personal essay depression

I Have Depression, and I'm Proof That You Never Know the Battle Someone Is Waging Inside

Updated on 2/27/2020 at 7:50 AM

I never thought I'd live to be 26 years old. You may be wondering why someone who seems perfectly healthy would have such a dark thought , and you would not be alone. But I'm proud to say that turning 26 has been one of the greatest accomplishments of my life.

If you checked my Instagram over the last few years, you would have seen me as the happiest girl in the world , traveling the globe teaching yoga and weightlifting. But keeping up that image grew exhausting, so I decided to be brave and tell my story. My story is not unique, but it's one that is rarely spoken about due to fear. Fear can be a crippling emotion, but it can also be a powerful tool.

Depression and anxiety are just like any other illness. They're nothing to hide away.

So I'm going to ask something scary: do the words "mental health" make you uncomfortable? They used to make me feel that way, too. But depression and anxiety are just like any other illness. They're nothing to hide away. In fact, these journeys should be shared and celebrated.

I have had anxiety for as long as I can remember. Growing up, it impacted every part of life. I would have panic attacks before going to school, sleepless nights before games or tests, endless thoughts of everyone being against me, and days where I felt completely alone in the world. In college, things got worse. I became extremely depressed. I partied every chance I got. I hung out with people who fed the worst parts of me. I protected myself by flashing a big smile and playing the part of the bubbly sorority girl. I told myself that depression is scary and no one wants to hear about that .

Keep it hidden and keep smiling.

A few years later, at the age of 20, my smile had fallen and I had given up. The thought of waking up the next morning was too much for me to handle. I was no longer anxious or sad; instead I felt numb, and that's when things took a turn for the worse. I called my dad, who lived across the country, and for the first time in my life, I told him everything. It was too late, though. I was not calling for help. I was calling to say goodbye.

Miraculously, he convinced me to hang on for a few more hours. Had he not boarded the very next flight to me, I would not be here right now.

That is when I started my long and continuous journey to get healthy. I worked with doctors and therapists , but I still struggled. Until one day my dad took me to a CrossFit gym by my school and for the first time I picked up a barbell. It instantly became my place to escape, my outlet, my medicine . I did not go more than a day without having a bar in my hand, but weightlifting and fitness were not enough alone.

After a year or so, the depression crept back in. I channeled the inner strength I had built in the gym and asked for help. This is when I began working with a new therapist, one who believed that depression decreased by age 26. I have no idea if this is true, but in yoga, you're taught not to ask if the thought is true, but rather if the thought serves you. So I hung onto this. When I fell into a really bad spell, I reminded myself, "Just a few more years. Hang on until you are 26. It will get better."

I kept lifting. I kept working. I kept growing.

As an Olympic weightlifting coach and yoga teacher, people tell me all the time how strong I am, which used to make me feel like a total fraud. But today, I am 26 years old. Today, I'm proudly sharing something I felt so ashamed of for so many years , and that's because I'm strong. I have a strength that this illness will never be able to match, not at 26 or any age after that.

The charity Project Semicolon is close to my heart. The idea behind it : "a semicolon represents a sentence an author could have ended, but chose not to." My story isn't over, and each chapter is a lot brighter, a lot bolder, and filled with a lot of fun new characters. There's always more to come. We just need to continue writing.

If you or a loved one are in need of any help, the National Suicide Prevention organization has several resources and a 24/7 lifeline at 1-800-273-8255.

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This is what depression feels like

• Courtenay Harris Bond

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• Depression: Major Depression & Unipolar Varieties

A Personal Story of Living through Depression

John Folk-Williams has lived with major depressive disorder since boyhood and finally achieved full recovery just a few years ago. As a survivor of ...Read More

A recovery story is a messy thing. It has dozens of beginnings and no final ending. Most of the conflict and drama is internal, and there’s a lot more inaction than action. The lead character hides in the shadows much of the time, so you can’t even see what’s going on.

I joined up with depression around the age of 8. There are snapshots of me in the shabby brown jacket I liked to wear. My mom took beautiful photographs, and there are lots of me in moody shadows, looking as down as could be.

She had her own depression to worry about. My typical memory of her from that time brings back a couch-bound, often napping, mother. She explained her sleep problem as a condition she called knockophasia – a term I’ve never been able to find in any dictionary. A few minutes after lying down, snap! Sound asleep. No one mentioned strange emotional problems or mental illness in those days. My parents occasionally talked about someone having a nervous breakdown as if they had died. There was no hint of a need to get help for my mother, much less for me. No one worried about me since I was a star in school, self-contained and impressive to teachers for being so mature, so adult.

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Migraine headaches started then, and increasingly intense anxiety about school. I missed many days, felt shame as if I were faking, and obsessed over every one of my failings. I spent long hours alone in my room.

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Through my teenage years, depression went underground. Feelings were dangerous. There were too many angry and violent ones shaking the house for me to add to them. So I kept emotion under wraps, even more so than in childhood. Nothing phased me outside the house and even at home I showed almost no sign of reaction to anything, even while churning with fear and anguish.

It was in my 20s that I broke open, and streams of depression, fear, panic, obsessive love and anger flowed out. In response to a panic attack that lasted for a week, I saw a psychiatrist. In one marathon session of 3 hours he helped me put the panic together with frightening episodes from my family life. I was cured on the spot but never went back to him. It was too soon to do any more.

It took another crisis a few years later to get me back to a psychiatrist and my first experience with medication – Elavil. But I had no idea what it was. I took something in the morning to get me going and something at night to help me sleep. I took it short term, got through the crisis but continued in therapy. From there I was steadily seeing psychiatrists in various cities for the next 8 years. But no one mentioned depression.

I first saw the word applied to my condition in a letter one psychiatrist wrote to the draft board during the Vietnam era. But I wasn’t treated for that problem. Therapy in those days was still in the Freudian tradition, and it was all about family life and conflict. Depression was a springboard for going deeper. Digging up the past to understand present problems was a tremendous help, and it changed me in many ways. But depression was still there in various forms, reappearing regularly for the next couple of decades. There were wonderfully happy and successful times as well, but I had these ups and downs through marriage, children and a couple of careers.

Gradually, depression became so disruptive that my wife couldn’t take it anymore and demanded I get help. So I finally did. This was the 1990s. Prozac had arrived, and I started a tour of medication over the next dozen years that didn’t do much at all. Nor did therapy, though two psychiatrists helped me to understand the more destructive patterns in my way of living.

Depression pushed into every corner of my existence, and both work and family life became more and more difficult. The medications only seemed to deaden my feelings and make me feel detached from everyone and immune to every pressure. It was like having pain signals turned off. There was no longer any sign coming from my body or brain that something might be wrong. I felt “fine” but relationships and work still went to hell.

The strange thing was that after all these years of living with it, I didn’t know very much about depression. I thought it was entirely a problem of depressed mood and loss of the energy and motivation. As things got worse, I finally started to read about it in great depth.

I was amazed to learn the full scope of depression and how pervasive it could be throughout the mind and body. I finally had a coherent, comprehensive picture of what depression was.

That was a big step because I could at last imagine the possibility of getting better. I could see that I wasn’t worthless by nature, that there were reasons my mind had trouble focusing and that the frequent slowdown in my speech and thinking was also rooted in this illness. Perhaps the right treatment could bring about fundamental changes after all.

There were still traps ahead, though. I became obsessed with the idea of depression as a brain disease. I studied all the forms of depression, the neurobiology and endless research studies. That was a good thing to do, but after awhile I was looking more at “Depression” than the details of my own version of the illness.

I wondered how many diagnostic categories I fitted into. For sure I had one or more of the anxiety disorders. Perhaps I fit into bipolar II instead of major depressive disorder. What about dissociation? I read the research study findings as if they were announcing my fate.

It was comforting to know I had a “real” disease. Not only could I answer any naysayers about the reality of depression. I also had a weapon to fight my internalized stigma, the lingering doubt that anything was wrong with me. I used to think that maybe I really was using the illness as a way to avoid life and cover up my own weakness. Here was proof that depression wasn’t all in my imagination but in my brain chemistry.

Neurobiology was far beyond my control. I couldn’t recover by myself. Doctors had to cure me through medication or other treatments, like ECT. However, that meant my hopes were pinned on them, not on my own role in getting better.

When the treatments failed to work, I got desperate that there would never be an end to depression. Hope in the future fell apart. My life would continue to run down. Could it even lead to suicide, as it had for friends of mine?

Fortunately, as I learned more, I listened to the experts who had a much broader view of the causes of the illness. Peter Kramer’s overview of research in Against Depression made it clear to me that contributors to the illness could include genetic inheritance, family history, traumatic events and stress as well as the misfiring of multiple body systems. No one could point to a single cause or boil it down to a few neurotransmitters.

So I went back to basics and looked much more closely at the particular symptoms I faced. I tracked the details in everyday living and saw that I needed to take the lead in recovery. Medication – when it had any effect at all – played a modest role in taking the edge off the worst symptoms. That bit of relief gave me the energy and presence of mind to work on the emotional and relationship impacts, to try to straighten out the parts of my life I had some control over.

I was determined to stop the waste of life in depression. I got back into psychotherapy and tried many types of self-help as well. Many didn’t work at all, but something inside pushed me to keep trying, despite setbacks.

One of the most important efforts was writing about my experience with depression. Writing is one way I discover things, but a deep fear had blocked me from doing it for years. I can see now that the real reason I got stuck was that I had been trying to write about everything but depression. When I could finally take that on directly, writing came naturally.

Blogging turned out to be the right medium. It was manageable even when I was down. The online community of people who lived with depression gave me a form of support that I had never had before. Another decisive step was getting out of high-stress work that I had been less and less able to do effectively. Taking that constant burden away restored a deep sense of vitality.

After all this, recovery finally started to happen. It took me by surprise, and for a long time I didn’t trust that it would last. But something had changed deep down. I believed in myself again, and the inner conviction of worthlessness disappeared.

I had found a deeply satisfying purpose in writing, as well as the energy and humor to do what I wanted to do. I regained the awareness and emotional presence to be a part of my family again, instead of the hidden husband and dad.

As anyone dealing with life-long depression will tell you, setbacks happen. There’s no simple happy ending. But if you’re lucky, an inner shift occurs, and the new normal is a decent life rather than depression. Self-awareness is key to good mental health. Take our online depression quiz today.

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My battle with depression and the two things it taught me

I’ve spent a decade slipping in and out of depression, but thanks to the right medicine and loving people, I’m back to being me again

I t’s often said that depression isn’t about feeling sad. It’s part of it, of course, but to compare the life-sapping melancholy of depression to normal sadness is like comparing a paper cut to an amputation. Sadness is a healthy part of every life. Depression progressively eats away your whole being from the inside. It’s with you when you wake up in the morning, telling you there’s nothing or anyone to get up for. It’s with you when the phone rings and you’re too frightened to answer it.

It’s with you when you look into the eyes of those you love, and your eyes prick with tears as you try, and fail, to remember how to love them. It’s with you as you search within for those now eroded things that once made you who you were: your interests, your creativity, your inquisitiveness, your humour, your warmth. And it’s with you as you wake terrified from each nightmare and pace the house, thinking frantically of how you can escape your poisoned life; escape the embrace of the demon that is eating away your mind like a slow drip of acid.

And always, the biggest stigma comes from yourself. You blame yourself for the illness that you can only dimly see.

So why was I depressed? The simple answer is that I don’t know. There was no single factor or trigger that plunged me into it. I’ve turned over many possibilities in my mind. But the best I can conclude is that depression can happen to anyone. I thought I was strong enough to resist it, but I was wrong. That attitude probably explains why I suffered such a serious episode – I resisted seeking help until it was nearly too late.

Let me take you back to 1996. I’d just begun my final year at university and had recently visited my doctor to complain of feeling low. He immediately put me on an antidepressant, and I got down to the business of getting my degree. The pills took a few weeks to work, but the effects were remarkable. Too remarkable. About six weeks in I was leaping from my bed each morning with a vigour and enthusiasm I had never experienced, at least not since early childhood. I started churning out first-class essays and my mind began to make connections with an ease that it had never done before.

The only problem was that the drug did much more. It broke down any fragile sense I had of social appropriateness. I’d frequently say ridiculous and painful things to people I had no right to say them to. So, after a few months, I decided to stop the pills. I ended them abruptly, not realising how foolish that was – and spent a week or two experiencing brain zaps and vertigo. But it was worth it. I still felt good, my mind was still productive, and I regained my sense of social niceties and appropriate behaviour.

I had hoped that was my last brush with mental health problems, but it was not to be.

On reflection, I realise I have spent over a decade dipping in and out of minor bouts of depression – each one slightly worse than the last.

Last spring I was in the grip of depression again. I couldn’t work effectively. I couldn’t earn the income I needed. I began retreating to the safety of my bed – using sleep to escape myself and my exhausted and joyless existence.

So I returned to the doctor and told her about it. It was warm, and I was wearing a cardigan. “I think we should test your thyroid,” she said. “But an antidepressant might help in the meantime.” And here I realised, for all my distaste for the stigmatisation of mental illness, that I stigmatised it in myself. I found myself hoping my thyroid was bust. Tell someone your thyroid’s not working, and they’ll understand and happily wait for you to recover. Tell them you’re depressed, and they might think you’re weak, or lazy, or making it up. I really wanted it to be my thyroid. But, of course, when the blood test came back, it wasn’t. I was depressed.

So I took the antidepressant. And it worked. To begin with. A month into the course, the poisonous cloud began to lift and I even felt my creativity and urge to write begin to return for the first time in years. Not great literature, but fun to write and enjoyed by my friends on social media. And tellingly, my wife said: “You’re becoming more like the person I first met.”

It was a turning point. The drug had given me objectivity about my illness, made me view it for what it was. This was when I realised I had been going through cycles of depression for years. It was a process of gradual erosion, almost impossible to spot while you were experiencing it. But the effects of the drug didn’t last. By September I was both deeply depressed and increasingly angry, behaving erratically and feeling endlessly paranoid.

My wife threatened to frog march me back to the doctor, so I made an appointment and was given another drug. The effects have been miraculous. Nearly two months in and I can feel the old me re-emerging. My engagement and interest is flooding back. I’m back at work and I’m producing copy my clients really love. Only eight weeks ago, the very idea that I would be sitting at home tapping out a blog post of this length on my phone would have made me grunt derisively. But that is what has happened, and I am truly grateful to all those who love and care for me for pushing me along to this stage.

And now, I need to get back to work. Depression may start for no definable reason, but it leaves a growing trail of problems in its wake. The more ill I got, the less work I could do, the more savings I spent and the larger the piles of unpaid bills became. But now I can start to tackle these things.

If you still attach stigma to people with mental illness, please remember two things. One, it could easily happen to you. And two, no one stigmatises their illness more than the people who suffer from it. Reach out to them.

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Essays About Depression: Top 8 Examples Plus Prompts

Many people deal with mental health issues throughout their lives; if you are writing essays about depression, you can read essay examples to get started.

An occasional feeling of sadness is something that everyone experiences from time to time. Still, a persistent loss of interest, depressed mood, changes in energy levels, and sleeping problems can indicate mental illness. Thankfully, antidepressant medications, therapy, and other types of treatment can be largely helpful for people living with depression.

People suffering from depression or other mood disorders must work closely with a mental health professional to get the support they need to recover. While family members and other loved ones can help move forward after a depressive episode, it’s also important that people who have suffered from major depressive disorder work with a medical professional to get treatment for both the mental and physical problems that can accompany depression.

If you are writing an essay about depression, here are 8 essay examples to help you write an insightful essay. For help with your essays, check out our round-up of the best essay checkers .

• 1. My Best Friend Saved Me When I Attempted Suicide, But I Didn’t Save Her by Drusilla Moorhouse
• 2. How can I complain? by James Blake
• 3. What it’s like living with depression: A personal essay by Nadine Dirks
• 4. I Have Depression, and I’m Proof that You Never Know the Battle Someone is Waging Inside by Jac Gochoco
• 5. Essay: How I Survived Depression by Cameron Stout
• 6. I Can’t Get Out of My Sweat Pants: An Essay on Depression by Marisa McPeck-Stringham
• 7. This is what depression feels like by Courtenay Harris Bond

8. Opening Up About My Struggle with Recurring Depression by Nora Super

1. what is depression, 2. how is depression diagnosed, 3. causes of depression, 4. different types of depression, 5. who is at risk of depression, 6. can social media cause depression, 7. can anyone experience depression, the final word on essays about depression, is depression common, what are the most effective treatments for depression, top 8 examples, 1.  my best friend saved me when i attempted suicide, but i didn’t save her  by drusilla moorhouse.

“Just three months earlier, I had been a patient in another medical facility: a mental hospital. My best friend, Denise, had killed herself on Christmas, and days after the funeral, I told my mom that I wanted to die. I couldn’t forgive myself for the role I’d played in Denise’s death: Not only did I fail to save her, but I’m fairly certain I gave her the idea.”

Moorhouse makes painstaking personal confessions throughout this essay on depression, taking the reader along on the roller coaster of ups and downs that come with suicide attempts, dealing with the death of a loved one, and the difficulty of making it through major depressive disorder.

2.  How can I complain?  by James Blake

“I wanted people to know how I felt, but I didn’t have the vocabulary to tell them. I have gone into a bit of detail here not to make anyone feel sorry for me but to show how a privileged, relatively rich-and-famous-enough-for-zero-pity white man could become depressed against all societal expectations and allowances. If I can be writing this, clearly it isn’t only oppression that causes depression; for me it was largely repression.”

Musician James Blake shares his experience with depression and talks about his struggles with trying to grow up while dealing with existential crises just as he began to hit the peak of his fame. Blake talks about how he experienced guilt and shame around the idea that he had it all on the outside—and so many people deal with issues that he felt were larger than his.

3.  What it’s like living with depression: A personal essay   by Nadine Dirks

“In my early adulthood, I started to feel withdrawn, down, unmotivated, and constantly sad. What initially seemed like an off-day turned into weeks of painful feelings that seemed they would never let up. It was difficult to enjoy life with other people my age. Depression made typical, everyday tasks—like brushing my teeth—seem monumental. It felt like an invisible chain, keeping me in bed.”

Dirks shares her experience with depression and the struggle she faced to find treatment for mental health issues as a Black woman. Dirks discusses how even though she knew something about her mental health wasn’t quite right, she still struggled to get the diagnosis she needed to move forward and receive proper medical and psychological care.

4.  I Have Depression, and I’m Proof that You Never Know the Battle Someone is Waging Inside  by Jac Gochoco

“A few years later, at the age of 20, my smile had fallen, and I had given up. The thought of waking up the next morning was too much for me to handle. I was no longer anxious or sad; instead, I felt numb, and that’s when things took a turn for the worse. I called my dad, who lived across the country, and for the first time in my life, I told him everything. It was too late, though. I was not calling for help. I was calling to say goodbye.”

Gochoco describes the war that so many people with depression go through—trying to put on a brave face and a positive public persona while battling demons on the inside. The Olympic weightlifting coach and yoga instructor now work to share the importance of mental health with others.

5.  Essay: How I Survived Depression   by Cameron Stout

“In 1993, I saw a psychiatrist who prescribed an antidepressant. Within two months, the medication slowly gained traction. As the gray sludge of sadness and apathy washed away, I emerged from a spiral of impending tragedy. I helped raise two wonderful children, built a successful securities-litigation practice, and became an accomplished cyclist. I began to take my mental wellness for granted. “

Princeton alum Cameron Stout shared his experience with depression with his fellow Tigers in Princeton’s alumni magazine, proving that even the most brilliant and successful among us can be rendered powerless by a chemical imbalance. Stout shares his experience with treatment and how working with mental health professionals helped him to come out on the other side of depression.

6.  I Can’t Get Out of My Sweat Pants: An Essay on Depression  by Marisa McPeck-Stringham

“Sometimes, when the depression got really bad in junior high, I would come straight home from school and change into my pajamas. My dad caught on, and he said something to me at dinner time about being in my pajamas several days in a row way before bedtime. I learned it was better not to change into my pajamas until bedtime. People who are depressed like to hide their problematic behaviors because they are so ashamed of the way they feel. I was very ashamed and yet I didn’t have the words or life experience to voice what I was going through.”

McPeck-Stringham discusses her experience with depression and an eating disorder at a young age; both brought on by struggles to adjust to major life changes. The author experienced depression again in her adult life, and thankfully, she was able to fight through the illness using tried-and-true methods until she regained her mental health.

7.  This is what depression feels like  by Courtenay Harris Bond

“The smallest tasks seem insurmountable: paying a cell phone bill, lining up a household repair. Sometimes just taking a shower or arranging a play date feels like more than I can manage. My children’s squabbles make me want to scratch the walls. I want to claw out of my own skin. I feel like the light at the end of the tunnel is a solitary candle about to blow out at any moment. At the same time, I feel like the pain will never end.”

Bond does an excellent job of helping readers understand just how difficult depression can be, even for people who have never been through the difficulty of mental illness. Bond states that no matter what people believe the cause to be—chemical imbalance, childhood issues, a combination of the two—depression can make it nearly impossible to function.

“Once again, I spiraled downward. I couldn’t get out of bed. I couldn’t work. I had thoughts of harming myself. This time, my husband urged me to start ECT much sooner in the cycle, and once again, it worked. Within a matter of weeks I was back at work, pretending nothing had happened. I kept pushing myself harder to show everyone that I was “normal.” I thought I had a pattern: I would function at a high level for many years, and then my depression would be triggered by a significant event. I thought I’d be healthy for another ten years.”

Super shares her experience with electroconvulsive therapy and how her depression recurred with a major life event despite several years of solid mental health. Thankfully, Super was able to recognize her symptoms and get help sooner rather than later.

7 Writing Prompts on Essays About Depression

When writing essays on depression, it can be challenging to think of essay ideas and questions. Here are six essay topics about depression that you can use in your essay.

Depression can be difficult to define and understand. Discuss the definition of depression, and delve into the signs, symptoms, and possible causes of this mental illness. Depression can result from trauma or personal circumstances, but it can also be a health condition due to genetics. In your essay, look at how depression can be spotted and how it can affect your day-to-day life. 

Depression diagnosis can be complicated; this essay topic will be interesting as you can look at the different aspects considered in a diagnosis. While a certain lab test can be conducted, depression can also be diagnosed by a psychiatrist. Research the different ways depression can be diagnosed and discuss the benefits of receiving a diagnosis in this essay.

There are many possible causes of depression; this essay discusses how depression can occur. Possible causes of depression can include trauma, grief, anxiety disorders, and some physical health conditions. Look at each cause and discuss how they can manifest as depression.

There are many different types of depression. This essay topic will investigate each type of depression and its symptoms and causes. Depression symptoms can vary in severity, depending on what is causing it. For example, depression can be linked to medical conditions such as bipolar disorder. This is a different type of depression than depression caused by grief. Discuss the details of the different types of depression and draw comparisons and similarities between them.

Certain genetic traits, socio-economic circumstances, or age can make people more prone to experiencing symptoms of depression. Depression is becoming more and more common amongst young adults and teenagers. Discuss the different groups at risk of experiencing depression and how their circumstances contribute to this risk.

Social media poses many challenges to today’s youth, such as unrealistic beauty standards, cyber-bullying, and only seeing the “highlights” of someone’s life. Can social media cause depression in teens? Delve into the negative impacts of social media when writing this essay. You could compare the positive and negative sides of social media and discuss whether social media causes mental health issues amongst young adults and teenagers.

This essay question poses the question, “can anyone experience depression?” Although those in lower-income households may be prone to experiencing depression, can the rich and famous also experience depression? This essay discusses whether the privileged and wealthy can experience their possible causes. This is a great argumentative essay topic, discuss both sides of this question and draw a conclusion with your final thoughts.

When writing about depression, it is important to study examples of essays to make a compelling essay. You can also use your own research by conducting interviews or pulling information from other sources. As this is a sensitive topic, it is important to approach it with care; you can also write about your own experiences with mental health issues.

Tip: If writing an essay sounds like a lot of work, simplify it. Write a simple 5 paragraph essay instead.

FAQs On Essays About Depression

According to the World Health Organization, about 5% of people under 60 live with depression. The rate is slightly higher—around 6%—for people over 60. Depression can strike at any age, and it’s important that people who are experiencing symptoms of depression receive treatment, no matter their age. 

Suppose you’re living with depression or are experiencing some of the symptoms of depression. In that case, it’s important to work closely with your doctor or another healthcare professional to develop a treatment plan that works for you. A combination of antidepressant medication and cognitive behavioral therapy is a good fit for many people, but this isn’t necessarily the case for everyone who suffers from depression. Be sure to check in with your doctor regularly to ensure that you’re making progress toward improving your mental health.

If you’re still stuck, check out our general resource of essay writing topics .

Amanda has an M.S.Ed degree from the University of Pennsylvania in School and Mental Health Counseling and is a National Academy of Sports Medicine Certified Personal Trainer. She has experience writing magazine articles, newspaper articles, SEO-friendly web copy, and blog posts.

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Stigma and Living with Depression

Looking back on my life, I consider myself very fortunate. I married an amazing woman; and we have been married 25 years. We have raised two sons of whom we are very proud. I was raised in a loving, supportive home. Both of my parents were active in my childhood. I served honorably as Marine. Work in a job I enjoy and will be able to work the same job in to retirement. Have a nice home in a safe neighborhood. Have lots of friends and many of my family live nearby.

You hear this and may be thinking “What does he have to complain about?” And you may be right. But I also have a dark side that I don’t let many people see. A side I spent my life ignoring and many times waking hoping it doesn’t surface. It’s a side me I spent a lot of time embarrassed by it. That side of me has a name. Depression.

Those who know me usually never know I suffer depression. I have two sides. The outer self. That is the one most people see. Most of the time, I am able to show that I’m content, joyful, and entertaining; but it takes a lot of energy to maintain it.

The other is my inner self. It is stealthy and lurks in the shadows of my mind as an undercurrent that I seldom talked about, rarely show, or can really even explain.

Before I got a proper diagnosis, and really learned about depression, I misunderstood really what it was – and why I fought so hard to deny it. I misunderstood and thought depression meant being sad, mopey, withdrawn, and moody. Of course, I’ve been all of those things at various times, but I didn’t live like that so I can’t be depressed. However, I was completely off course. It is nothing like I thought it was.

Instead, I refused to face, and wouldn’t share the feelings and thoughts with anyone. I feared that no one would understand and would think I was attention seeking—or worse—lying. I felt I was the only one who was like this. That there was something wrong with me. I had no idea what it was, how to combat it, or what to do about it. So I ignored it.

I’ve had mental illness my whole life. There isn’t a time I can remember where it wasn’t present. It sits there like a fog. Sometimes it is merely a mist, tingling my thoughts. Other times it’s a pervasive thick, dark shroud. It’s the times when the thoughts are darkest that are most debilitating. These are the times that scare me.

It is my hope that my story will help others. Before I started writing this, I asked friends to help me on an experiment. I asked: 1) when they first met me, what was their impression; 2) And over time what do they think of me now.

The responses were overwhelming and positive:

“A stand-up gentleman who was true to his word. Enjoys being with people.” “Resilient and sarcastic.” “A man of integrity, a loyal friend to many, very thoughtful.” “Great guy with a super sense of humor.” “A great friend and excellent teacher.” “Kind, honest, and considerate.” “Principled yet funny.” “Caring and loyal friend.” “I learn and enjoy seeing the world through your eyes.”

Hearing these wonderful words, while cathartic and moving, only frustrates Depression and stokes the fires of self-doubt. The inner self is always chittering away at me. It wants to be surreptitious. It tells me everyone will see me as I really am: an emotional wreck; a procrastinator; a fraud who has managed to fool everyone.

So, instead I “tough it out” and “put on the brave face.” If I pretend it isn’t there, hopefully no one will notice. However, putting on this public persona is emotionally taxing and draining. Eventually it takes its toll. I progressively become numb; and eventually have to completely withdrawal. I stay in that state until it passes – whether a day, several days or sometimes a week.

Although, sometimes it won’t pass. It’s a feeling as though I can’t recharge my drained mental energy. It’s those times when that inner self takes completely over; and I’m filled with unceasing anxiety and utter despair. All I want to do is sleep or cry or hide. I try to fight the feelings, but I sink into depths where I can’t manage them any longer. They become relentless wave that batters me until I have nothing more to fight against it. A fear that I can never get back to being “normal” again.

Sadly, that has happened a few times, and twice with terrible consequences. Those two times I attempted suicide. Looking back, I can remember those nights vividly, and even remember what dark thoughts I had. That utterly scares me.

Yet, through all of this, a life changing event occurred that forced me to face this inner self. I started going to therapy and finally admitted I needed medical help. I explained to my doctor about my depression and anxiety and was referred to a psychiatrist. It took different medicines and adjustments until the right ones worked. When it did, it was life altering. I could finally see through the fog.

Today, that inner self pushes his way in less and less. I don’t think he’ll ever really go away. But when he does come back, I feel empowered to keep him weak with less influence. The journey has been long. But I remain hopeful and look forward to each day.

No matter the great things and accomplishments we have in life, none of those diminish the depression. It’s a pervasive illness that can strike anyone. Just remember we’re never alone. It’s not a weakness to ask for help. There are many out there who love you.

Let’s Talk About Depression: A Personal Narrative .

Trigger warning: references to depression, suicide and self-harm .

It was an exciting vacation until I woke up in the ICU in a hospital in Nasik. I was told I met with an almost fatal accident. The driver died on the spot but I did not come to know until a few months had elapsed. I underwent multiple surgeries and my head had to be tonsured. My otherwise clear face bore deep scars and stitch marks. My spleen had to be removed, which resulted in a long scar on my stomach that will neither fade nor vanish. I got the best medical care and I constantly reminded myself that it could have been worse.

For almost six months, I had family, friends and everyone visiting. But as time passed, I felt something was not right with me. I started feeling lonely and disconnected from everyone. I hated the scars and marks and felt dejected. Every time I looked at my tonsured head, my eyes would well up, despite consoling myself for not liking the way I felt and I looked. It took me a great deal of patience to accept what had happened.

But the demons in my head had already started enjoying themselves at my expense. I started getting sleepless nights. I lost interest in everything. All I wanted to do was sit in a dark room. My energy levels depleted at an alarming rate. All I wanted to do was just lie in bed and avoid any kind of contact with the outside world. I would not want to eat anything. My taste buds seemed to have died. No matter what I ate, I would feel as if my taste buds have gone numb. I no longer enjoyed eating.

The more I read about depression, the more I realised that it is treatable and can be cured with timely and effective intervention.

I started getting thoughts of suicide and self-harm. I had a strong urge to jump off from the terrace. My coping mechanism shut down. I stopped relating to anything. The worst part was the absence of feelings. I neither felt happy nor sad. I stopped aspiring.  I stopped learning and growing. Initially, I thought I was being lazy. But things only started getting worse. I knew I had to take help because it was getting pretty bad and living in self-denial mode wasn’t helping me at all. I realised that mental health issues are like any other disease that can be cured with intervention. So one day I took an online test on mental health and even visited a shrink. Both spelt out DEPRESSION.

I couldn’t believe that a livewire like me could be depressed. I started questioning myself. What was I depressed about? What was bothering me and what could I do to help myself? I could not find concrete answers. The shrink put me on medication and it helped me to at least sleep at night. I have always been anti-medicine and paranoid about side effects, so I stopped it mid-way and told myself that I would deal with it myself. I started reading about depression. I started talking about depression and I realised that depression is more common than we think.

According to the World Health Organisation, “Globally, depression is the top cause of illness and disability among young and middle-aged populations. India is home to an estimated 57 million people affected by depression. Interestingly, a higher prevalence of depression among women and working-age adults (20-69 years) have been consistently reported by Indian studies.”

The more I read about depression, the more I realised that it is treatable and can be cured with timely and effective intervention. I was determined to help myself and others, especially women. I had created a Whatsapp group and I named it ‘Let’s Talk’. I had started the group before my accident. I added a few of my friends to the group and encouraged them to talk and share.

India is the country with the most depression cases in the world, according to the World Health Organisation, followed by China and the USA.

Coincidentally, Depression – Let’s Talk was the slogan for World Health Day 2017.  2017 was the darkest year for me as I was trying to get back on my feet after my accident in November 2016. I was determined to at least start talking about depression. I started telling women that talking to each other would be more helpful than talking about each other. I wanted to form a support group and help as many people as I could.

But sadly, most people live in self-denial and some of them would not take depression seriously. It was only when I talked in private to people, I realised that the monster called depression was for real and it could affect a man, woman or a child. India is the country with the most depression cases in the world, according to the World Health Organisation, followed by China and the USA. All the more reason to ACT now!

In my case, writing and talking is helpful. I have my rough days and a part of me is still to come to terms with the post-traumatic stress disorder.  But I want to tell everyone that we need to be heard without judgement or criticism. I always encourage people to talk and open up as I feel that is the first step. We heal the moment we are heard.

Also Read:  The Yellow Wallpaper Review: When Medical Science Failed Women

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Addressing Depression in Your Personal Statement

• college application essays
• essay topic

Did you know 20% of teenagers experience depression before reaching adulthood? It is also during this time that college applicants have to answer the most intimate question in order to gain acceptance at their dream school. What defines you?

While it may feel extremely vulnerable to talk about your experience with depression, don’t let that immediately deter you from choosing it as your personal statement essay topic. Here are 5 examples that may help you approach the topic in an essay:

UC Irvine ‘17

Throughout the past few years, I have gone through depression. The inability to focus not only in school, but also in life, is something I have struggled to overcome. The majority of the time, I am able to successfully distinguish my emotions from my academics because of my overly organized tendencies. At other times, the feelings that come with depression are inevitable. Depression, for me, is hopelessness. My biggest struggle with depression is not being able to see the light at the end of the tunnel; therefore, this way of thinking has caused me to feel unmotivated, alone, and frightened. Because of this, I have spent endless nights contemplating my life till 4 or 5 in the morning, I have no motivation to wake up in the mornings, and I feel pain and grief on a daily basis. Keep reading.

Brittanybea

Uc berkeley ‘19.

On a warm August morning I sat shivering and shaking in the waiting room to my doctor’s office. I had my mother make the appointment but didn’t give her the reason; I’m not even sure I really knew the reason. I just knew something was wrong. The past five years had been all uphill - outwardly, at least. I was doing increasingly well in school, growing more independent, and had greater opportunities at my feet. Inwardly, however, was an entirely different story. Those five years felt like an upbeat movie I was watching while in my own personal prison. I was happy for the characters, even excited for their accomplishments. The problem was that my outward self was a character entirely distinct from the internal me. View full essay.

869749923096609FB

Williams college ‘19.

Perhaps the greatest blessing my parents have ever granted me was the move from our apartment in the Bronx to a two-family home in Queens, two blocks away from a public library. The library had all the boons my young heart could desire: bounties of books, air conditioning in the summer, and sweet solace from a dwelling teeming with the cries of an infant sister, a concept I couldn’t yet fathom. Read more.

When I was younger, people chided me for being pessimistic. It was my sincere belief that there were no rewards to be reaped from a life here on earth. I was bored, unhappy, and apathetic. War, injustice, environmental collapse, the mean thing X said to me the other day-it all made me see the world as a tumultuous and unpleasant place. Continue reading.  

879216135461584FB

Dish soap, pepper, a toothpick, and an empty pie tin. The first materials I ever used to perform a simple experiment in grade school. Looking back that would be the moment I fell in love with science. I can still feel the excitement I felt as I watched as the pepper dart off to the edges of the pie tin as I touched the water with the end of a soap coated toothpick. Though I didn’t have to question how or why the reaction happened, I never stopped wondering. It was then that a passion for science ignited in me. It was a fire in my soul that could never die out. However, I couldn’t have been more wrong. As I grew older, the fire within me began to dim and in the year 2012, it became extinguished; the world as I knew it had ended. View full profile.

While this essay topic helped these students gain acceptances to UC Irvine , UC Berkeley , Williams , Vassar and NYU , it doesn’t mean it will work in the exact same way for you. Brainstorm and think carefully about what you want to write in your personal statement and how you want to share your own, unique story. For more inspiration, AdmitSee has a database of 60,000+ successful college applications files waiting for you! 

About The Author

Frances was born in Hong Kong and received her bachelor’s degree from Georgetown University. She loves super sad drama television, cooking, and reading. Her favorite person on Earth isn’t actually a member of the AdmitSee team - it’s her dog Cooper.

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16 Personal Essays About Mental Health Worth Reading

Here are some of the most moving and illuminating essays published on BuzzFeed about mental illness, wellness, and the way our minds work.

BuzzFeed Staff

1. My Best Friend Saved Me When I Attempted Suicide, But I Didn’t Save Her — Drusilla Moorhouse

"I was serious about killing myself. My best friend wasn’t — but she’s the one who’s dead."

2. Life Is What Happens While You’re Googling Symptoms Of Cancer — Ramona Emerson

"After a lifetime of hypochondria, I was finally diagnosed with my very own medical condition. And maybe, in a weird way, it’s made me less afraid to die."

3. How I Learned To Be OK With Feeling Sad — Mac McClelland

"It wasn’t easy, or cheap."

4. Who Gets To Be The “Good Schizophrenic”? — Esmé Weijun Wang

"When you’re labeled as crazy, the “right” kind of diagnosis could mean the difference between a productive life and a life sentence."

5. Why Do I Miss Being Bipolar? — Sasha Chapin

"The medication I take to treat my bipolar disorder works perfectly. Sometimes I wish it didn’t."

6. What My Best Friend And I Didn’t Learn About Loss — Zan Romanoff

"When my closest friend’s first baby was stillborn, we navigated through depression and grief together."

7. I Can’t Live Without Fear, But I Can Learn To Be OK With It — Arianna Rebolini

"I’ve become obsessively afraid that the people I love will die. Now I have to teach myself how to be OK with that."

8. What It’s Like Having PPD As A Black Woman — Tyrese Coleman

"It took me two years to even acknowledge I’d been depressed after the birth of my twin sons. I wonder how much it had to do with the way I had been taught to be strong."

9. Notes On An Eating Disorder — Larissa Pham

"I still tell my friends I am in recovery so they will hold me accountable."

10. What Comedy Taught Me About My Mental Illness — Kate Lindstedt

"I didn’t expect it, but stand-up comedy has given me the freedom to talk about depression and anxiety on my own terms."

11. The Night I Spoke Up About My #BlackSuicide — Terrell J. Starr

"My entire life was shaped by violence, so I wanted to end it violently. But I didn’t — thanks to overcoming the stigma surrounding African-Americans and depression, and to building a community on Twitter."

12. Knitting Myself Back Together — Alanna Okun

"The best way I’ve found to fight my anxiety is with a pair of knitting needles."

13. I Started Therapy So I Could Take Better Care Of Myself — Matt Ortile

"I’d known for a while that I needed to see a therapist. It wasn’t until I felt like I could do without help that I finally sought it."

14. I’m Mending My Broken Relationship With Food — Anita Badejo

"After a lifetime struggling with disordered eating, I’m still figuring out how to have a healthy relationship with my body and what I feed it."

15. I Found Love In A Hopeless Mess — Kate Conger

"Dehoarding my partner’s childhood home gave me a way to understand his mother, but I’m still not sure how to live with the habit he’s inherited."

16. When Taking Anxiety Medication Is A Revolutionary Act — Tracy Clayton

"I had to learn how to love myself enough to take care of myself. It wasn’t easy."

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Not Just Sadness: Decomposing Depression

What stops us from completing the work of sorrow and getting rid of depression.

Posted March 27, 2024 | Reviewed by Davia Sills

• What Is Depression?
• Find a therapist to overcome depression
• Sadness often accompanies depression, but they are not the same thing.
• Depression has also been linked to repressed anger and fear.
• Addressing the many possible components of depression can help people recover from it.

I often hear my clients say, "I don't want to discuss this subject—I don't want to be sad and get depressed."

Depression is indeed accompanied by sadness, so connecting depression with sadness is common. But so is confusing these two conditions.

Sadness vs. Depression

Sadness is a normal reaction to adverse situations. It develops when expected gratification is unavailable because of a separation from or loss of something important. We process sadness by means of sorrow and letting go.

Depression is a more complex condition. In addition to unremitting sadness, depression is defined by low mood, apathy, lack of joy ( anhedonia ), and inability to concentrate and stay focused. Corpus Hippocraticum , the classic work published between 500 and 400 BC and attributed to Hippocrates, among other authors, includes one of the first attempts to describe depression as a medical condition. It places fear above sadness as a psychotic symptom of depression, thus postulating that fear can be a more significant factor in depression than sadness (9).

Researchers such as John Bowlby , the creator of attachment theory, have concluded that sadness often appears as a reaction to some forms of loss "of a loved person or else of familiar and loved places, or of social roles" (Bowlby, 1980). Depression is also closely related to loss and to fear that this loss will recur. Bowlby described depression as a "real or feared loss of the parent figure, either temporary or permanent," and believed vulnerability to depression derived from these early insecure attachments and experiences of early loss or abandonment.

We process sadness by means of sorrow and grieving to accept and let go of the things we cannot change. Grief tends to come in waves. In contrast, depression is unyielding. In this way, depression can be seen as the antithesis of grief. Nancy McWilliams says, "People who grieve normally tend not to get depressed, even though they can be overwhelmingly sad during the period that follows bereavement or loss" (7).

The major role of anger in depression has been long known to psychoanalytic researchers and clinicians. In his classic work, Mourning and Melancholia , Sigmund Freud , the founding father of psychoanalysis , a precursor to all modern therapies, viewed depression "as hate turned upon the self after the loss of an important love object" (1). His close associate Karl Abraham noted a propensity towards hatred in patients with depression based on temperament or early experience. The authors speculated two things: 1) the experience of premature loss creates vulnerability to depression, and 2) depression results from anger turned inward in response to loss.

The melancholic state that Freud was exploring exhibited lost connections to something important to the extent that the depressed individuals became so identified with this lost object that they kept it firmly within themselves. They were unable to establish a meaningful connection or part from it and grieve its loss. Sadness became inseparable from their condition.

In sadness, one knows what they have lost, but in depression, the loss is often indiscernible and can't be addressed consciously. It is often interpreted by the individual as a sign of their own inadequacy, unlovability, or damage. They feel rejected, abandoned, and angry toward themselves in the form of shame , self-criticism, and guilt that their "badness" might have driven this thing away from their life. Thus, they feel inherently corrupt.

There Is a Lot of Further Research Connecting Depression With Anger.

Friedman, A. S. (1970) found that individuals diagnosed with depression scaled higher on the Resentment subscale of the Buss-Durkee Inventory than non-depressed people. Resentment is defined here as "repressing the experience of the hostile affect from consciousness" (4). Subjects reported significantly less verbal open hostility but significantly more resentment. Becker & Lesiak (1977) found that in clinic outpatients, the severity of depression correlated with covert hostility, including guilt, resentment, irritability, and suspicion, but not with overt hostility.

In earlier research by Friedman et al. (10), people were asked if it is ever right to be angry. Hospitalized depressed patients answered "yes" significantly less often than non-depressed control subjects. This suggests difficulty with acceptance and expression of anger or aggression at the time of depression. Riley et al. (1989) concluded in their study that "the results […] generally support the hypothesis that depression is related to an inhibition in anger expression. The depressed group reported higher levels of anger suppression than either the normal or PTSD groups" (11).

In another study by Kellner, R., Hernandez, J., & Pathak, D. (1992), 100 participants diagnosed with depression were given an extensive questionnaire about their condition. In all four groups, depression predicted inhibited anger for both sexes.

Improvement in all domains of inwardly directed hostility has been reported with the alleviation of depression (Blackburn et al. 1979; Mayo 1978; Friedman 1970).

Goldman & Haaga (1995) connected both anger and fear in depression. In comparison to non-depressed subjects, depressed subjects express more anger toward close family members than to others. This finding seems plausible considering the high rates of marital conflicts in couples that include a depressed partner (Schmaling and Jacobson, 1990). The fear of expressing anger to other people was highly correlated with anger suppression because of the fear of the consequences of such expression.

Brody et al. (1999) demonstrated that, in comparison to the never-depressed control group, recovered depressed patients reported suppressing their anger and being afraid of expressing it because they viewed it as damaging toward other people. The authors hypothesized that anger inhibition may play a causal role in the recurrence of depression.

These findings link both anger and the fear of expressing it, causing depressed individuals to suppress their anger out of fear. Thus, the role of inhibited anger in depressive conditions seems to be crucial.

There might also be confusion when we describe sadness as opposed to anger. Castel, P.-H. (2016) indicates confusion between these notions:

The very fact of saying "You make me sad" to somebody often expresses not so much sadness as anger and resentment. From a more psychological standpoint, sadness is often consciously experienced as an inward rage barred from public display; anger, similarly, when not fully acted out, commonly reverts to grief and feelings of helplessness. The opposition of inward vs. outward feelings will often reflect socially coded constraints on the legitimacy of the public exhibition of affective states. Agitated and violent children may actually be sad, while passive or submissive women are internally consummated with rage. (2).

Researchers such as Arieti, Bemporad, and Bowlby view depression as a sadness that cannot be "metabolized," so the work of sorrow cannot be completed. Inhibited anger, fear of expressing it, and lack of knowledge or positive previous experience on how to express anger constructively might play a crucial role in hindering the process of sorrow to eventually be rid of sadness and the symptoms of depression.

When dealing with depression both on a personal and therapeutic level, we need to take into account the possible presence of suppressed anger and equip ourselves and our clients with tools to deal with and express it constructively. Nancy McWilliams (2011) suggests that depressed individuals be in long-term or open-ended therapy instead of a pre-set number of sessions. If they have sufficient time to recognize their anger in a therapeutic environment, they will be able to address it. McWilliams states:

Treatments that are arbitrarily limited to a certain number of sessions may provide welcome comfort during a painful episode of clinical depression, but the time-limited experience may be ultimately assimilated unconsciously by the depressive person as another relationship that was traumatically cut short—further evidence that the patient is a failure in maintaining attachments (7).

Recognizing inhibited anger in a depressive state, learning to express it constructively in a therapeutic environment, and addressing the fear of losing important relationships due to anger can be salubrious strategies in helping one alleviate the symptoms of depression.

1. Freud S. (1917). Mourning and Melancholia. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XIV (1914-1916).

2. Castel, P.-H. (2016). Loss, Bereavement, Mourning, and Melancholia: A Conceptual Sketch, in Defence of Some Psychoanalytic Views. In Sadness or Depression? (pp. 109-119).

3. Painuly, N., Sharan, P., & Mattoo, S. K. (2004). Relationship of anger and anger attacks with depression. European Archives of Psychiatry and Clinical Neuroscience, 255(4), 215–222.

4. Friedman, A. S. (1970). Hostility Factors and Clinical Improvement in Depressed Patients. Archives of General Psychiatry, 23(6), 524.

5. GOLDMAN, L., & HAAGA, D. A. F. (1995). Depression and the Experience and Expression of Anger in Marital and Other Relationships. The Journal of Nervous and Mental Disease, 183 (8), 505-509.

6. Busch FN (2009). Anger and depression. Advances in Psychiatric Treatment, 15(4):271-278.

7. McWilliams, Nancy. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). ISBN 978-1-60918-494-0.

8. Kellner, R., Hernandez, J., & Pathak, D. (1992). Self-Rated Inhibited Anger, Somatization and Depression. Psychotherapy and Psychosomatics, 57(3), 102–107.

9. Azzone, Paolo. Depression as a Psychoanalytic Problem. University Press of America, 2012.

10. Friedman AS, Granick S: A note on anger and aggression in old age. J Geront 18:283-285, 1963.

11. RILEY, W. T., TREIBER, F. A., & WOODS, M. G. (1989). Anger and Hostility in Depression. The Journal of Nervous and Mental Disease, 177(11), 668–674.

12. Allan, S., & Gilbert, P. (2002). Anger and anger expression in relation to perceptions of social rank, entrapment and depressive symptoms. Personality and Individual Differences, 32(3), 551–565.

Boris Herzberg has been working with individuals, couples and groups for more than a decade as a counselor, consultant and coach.

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Home — Essay Samples — Nursing & Health — Mental Health — My Struggle with Anxiety and Depression

My Struggle with Anxiety and Depression

• Categories: College Students Mental Health

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Published: Mar 16, 2024

Words: 751 | Pages: 2 | 4 min read

Table of contents

Personal experience, impact on college students, factors contributing to anxiety and depression in college students, seeking support and treatment.

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Personality and Depression: Explanatory Models and Review of the Evidence

Understanding the association between personality and depression has implications for elucidating etiology and comorbidity, identifying at-risk individuals, and tailoring treatment. We discuss seven major models that have been proposed to explain the relation between personality and depression, and we review key methodological issues, including study design, the heterogeneity of mood disorders, and the assessment of personality. We then selectively review the extensive empirical literature on the role of personality traits in depression in adults and children. Current evidence suggests that depression is linked to traits such as neuroticism/negative emotionality, extraversion/positive emotionality, and conscientiousness. Moreover, personality characteristics appear to contribute to the onset and course of depression through a variety of pathways. Implications for prevention and prediction of treatment response are discussed, as well as specific considerations to guide future research on the relation between personality and depression.

INTRODUCTION

The hypothesis that depression is linked to personality can be traced to antiquity, when Hippocrates, and later Galen, argued that particular “humors” were responsible for specific personality types and forms of psychopathology. In this article, we discuss the major conceptual models that have been proposed to explain the association between personality and depression, comment on some important methodological issues, and selectively review the empirical literature. Due to space limitations, we limit our review to nonbipolar forms of depression.

This literature has developed along several distinct lines: ( a ) early clinical psychiatrists’ descriptions of affective temperaments; ( b ) research on the structure and neurobiology of personality; ( c ) psychoanalytic and cognitive-behavioral theory and observations; and ( d ) developmental psychologists’ work on temperament. In recent years, there has been substantial convergence between these lines of work, and it is increasingly possible to view them within a single integrative framework. Understanding the associations between personality and depression has a number of potentially important implications for research and practice. First, personality traits associated with emotional experience, expression, and regulation may be intermediate phenotypes that provide more tractable targets for genetic and neurobiological research than depressive diagnoses ( Canli 2008 ). Second, personality may be useful in identifying more homogeneous subgroups of depressive disorders that differ in developmental trajectories and etiological influences (e.g., Beck 1983 ). Third, tracing the pathways between personality and depressive disorders can help elucidate more proximal processes involved in the development of mood disorders ( Compas et al. 2004 , Klein et al. 2008a , Lahey 2009 ). Fourth, personality may be useful in tailoring treatment ( Zinbarg et al. 2008 ) and predicting treatment response ( Quilty et al. 2008a ). Fifth, temperament/personality may provide a means to identify at-risk individuals who could benefit from prevention and early intervention efforts ( Kovacs & Lopez-Duran 2010 ). Finally, there is substantial comorbidity between depressive disorders and other forms of psychopathology. Some personality traits, such as neuroticism, are associated with multiple psychiatric conditions. Thus, personality could help explain patterns of comorbidity and point toward more etiologically relevant classification systems ( Brown & Barlow 2009 , Kotov et al. 2007 , Watson 2009 ).

THE CONSTRUCT OF PERSONALITY

Before addressing the relation between personality and depression, several conceptual issues regarding the construct of personality should be considered. First, personality has traditionally been conceptualized as having two components: temperament, which refers to biologically based, early-emerging, stable individual differences in emotion and its regulation, and character, which refers to individual differences due to socialization. However, the distinctions between these constructs are questionable, as a large body of evidence has accumulated indicating that personality traits have all the characteristics of temperament, including strong genetic and biological bases and substantial stability over the lifespan ( Krueger & Johnson 2008 , Watson et al. 2006 ). Hence, the terms “personality” and “temperament” are now often used interchangeably ( Caspi & Shiner 2006 , Clark & Watson 1999 ). As most research on personality in childhood has been conducted under the temperament rubric, in this review we refer to this work using the term “temperament” and reserve the term “personality” for discussing the literature on adolescents and adults. However, this is intended to reflect traditional usage rather than a conceptually meaningful distinction.

Second, a variety of personality classifications have been proposed over the past century, but in the 1980s they were integrated in a consensus taxonomy, the Five-Factor Model (FFM). The FFM recognized that personality is ordered hierarchically from a large number of specific traits to five general characteristics ( Digman 1994 , Goldberg 1993 , Markon et al. 2005 ). These “Big Five” traits are neuroticism, extraversion, conscientiousness, agreeableness, and openness to experience. Importantly, the FFM can be further reduced to three dimensions of negative emotionality, positive emotionality, and disinhibition versus constraint that form the next level of the personality hierarchy ( Clark & Watson 1999 , Markon et al. 2005 ). This “Big Three” model is used in studies of temperament as well as personality, although disinhibition is often labeled as effortful control in the child literature ( Caspi & Shiner 2006 , Rothbart & Bates 2006 ). The Big Five and Big Three schemes are closely related, with neuroticism being essentially identical to negative emotionality and extraversion corresponding to positive emotionality ( Clark & Watson 1999 , Markon et al. 2005 ); we refer to these two dimensions as neuroticism/negative emotionality (N/NE) and extraversion/positive emotionality (E/PE), respectively. Disinhibition does not have an exact counterpart in the FFM but instead reflects a combination of low conscientiousness and low agreeableness. Finally, openness to experience is outside the territory covered by the Big Three.

Third, there is increasing recognition that temperament and personality are not a fixed, static set of characteristics, but rather are dynamic constructs that develop over the lifespan and change in response to maturation and life circumstances ( Fraley & Roberts 2005 , Rothbart & Bates 2006 ). For example, although the rank-order stability of most personality traits is in the moderate range, it increases over the course of development ( Roberts & DelVecchio 2000 ). In addition, mean levels of conscientiousness and some facets of E/PE increase, and levels of N/NE decrease, over time, particularly in young adulthood ( Roberts et al. 2006 ). A number of processes contribute to stability and change of personality. For example, genes are a major influence on stability ( Krueger & Johnson 2008 , Kandler et al. 2010 ). In addition, people often select, create, and construe environments in ways that reinforce and maintain their initial trait dispositions ( Caspi & Shiner 2006 ). However, life stressors and major shifts in social roles and relationships can contribute to personality change ( Fraley & Roberts 2005 , Kandler et al. 2010 ). We consider the implications of these processes for the relation between personality and depression below.

MODELS OF PERSONALITY AND DEPRESSION

Classical models of personality-depression relations.

A variety of models of the relation between personality and mood disorders have been proposed (e.g., Akiskal et al. 1983 , M.H. Klein et al. 1993 , Krueger & Tackett 2003 ). These proposed relations include: ( a ) personality and depressive disorders have common causes; ( b ) personality and depressive disorders form a continuous spectrum; ( c ) personality is a precursor of depressive disorders; ( d ) personality predisposes to developing depressive disorders; ( e ) personality has pathoplastic effects on depression; ( f ) personality features are state-dependent concomitants of depressive episodes; and ( g ) personality features are consequences (or scars) of depressive episodes. The distinctions between some of these accounts are subtle (cf. Kendler & Neale 2010 ), and other models, as well as combinations of these scenarios, are plausible. However, these seven models provide a useful conceptual framework for approaching the issue.

These models can be divided into three groups. The first three models (common cause, continuum/spectrum, and precursor) view personality and depression as having similar causal influences but do not see one as having a causal influence on the other. The fourth and fifth models (predisposition and pathoplasticity) hold that personality has causal effects on the onset or maintenance of depression. Finally, the sixth and seventh models (concomitants and consequences) view depression as having a causal influence on personality. These models, and their unique predictions, are summarized in Table 1 .

Summary of key predictions of the classic models

The common cause model views personality and depressive disorders as distinct entities that arise from the same, or at least an overlapping, set of etiological processes. From this perspective, personality and depression are not directly related; rather, the association is due to a shared third variable. The common cause model would be supported by evidence that personality traits and depression have shared etiological influences.

The continuum/spectrum model emphasizes the conceptual overlap between depressive disorders and certain personality traits and argues for a fundamental continuity between them. A depressive diagnosis is thought to simply identify individuals who have the most extreme scores on a relevant trait. Like the common cause model, the continuum/spectrum model assumes that personality and depression arise from a similar, if not identical, set of causal factors. However, the continuum/spectrum model goes further in positing that the association between the trait and disorder should be fairly specific because they are on the same continuum. 1 Moreover, this association is expected to be nonlinear, so that almost nobody below the definitional threshold on the trait has the diagnosis but nearly everyone above the threshold meets the criteria. Thus, the continuum/spectrum model would be supported by evidence that the trait and depression are associated with the same etiological influences and that the trait-disorder relationship is fairly specific and nonlinear.

The precursor model views personality as an early manifestation or “forme fruste” of depressive disorder. Like the common cause and continuum/spectrum accounts, the precursor model posits that personality and depressive disorders are caused by similar etiologic factors. Also like the continuum/spectrum account, it implies considerable phenomenologic similarity between the relevant trait and depression. However, the precursor model differs from both of these other models in that it assumes a particular developmental sequence, with the personality traits being evident prior to the onset of depressive disorder. In other words, both the common cause and continuum/spectrum models assume a fixed clinical expression as traits or disorder, whereas the precursor model implies escalation from traits to disorder within individuals over time. Support for the precursor model would come from evidence that the trait and depression are associated with the same etiological influences and that individuals with high levels of the trait are at increased risk for developing the disorder over time. 2

The common cause, continuum/spectrum, and precursor models do not posit causal relations between personality and depression. In contrast, the predisposition model holds that personality plays a causal role in the onset of depression. However, the predisposition model overlaps with the precursor model in that both propose that the relevant traits are evident prior to the onset of depressive disorder. The major difference between these two accounts is that the precursor model assumes that personality and depression derive from the same set of etiological processes, but the predisposition model posits that the processes that underlie personality differ from those that lead to depression. Thus, the predisposition account implies a complex interplay among risk factors involving moderation and/or mediation, and this is what distinguishes it from the precursor model. 3 The most common example—the diathesis-stress model—conceptualizes personality as the diathesis and stress as a moderator that precipitates the onset of depressive disorder. Alternatively, stress may be a mediator, so that personality vulnerability leads to negative experiences (e.g., interpersonal rejection, job loss), which in turn increase the probability of a depressive episode. A second difference between these models is that the predisposition model does not assume any phenomenological links between personality traits and depressive symptoms. Consequently, the predisposing trait may not have any phenotypic similarity to depression. Thus, the two most critical sources of support for the predisposition model would involve demonstrating that individuals with the trait are at increased risk for subsequently developing depression, and that other variables play a role in mediating or moderating this transition.

The pathoplasticity model is similar to the predisposition model in that it also views personality as having a causal influence on depressive disorder. However, rather than contributing to the onset of depression, the pathoplasticity model posits that personality influences the expression of the disorder after onset. This influence can include the severity or pattern of symptomatology, course, and response to treatment. The pathoplasticity model would be supported by evidence that personality explains variation among depressed individuals in their clinical presentation or outcome.

The final two models also assume that there is a causal relation between personality and depression. However, these models reverse the direction of causality. In the concomitants (or state-dependent) model, assessments of personality are colored, or distorted, by the individual’s mood state. This model implies that personality returns to its baseline form after recovery from the episode. In contrast, the consequences (or scar) model holds that depressive episodes have an enduring effect on personality, such that changes in personality persist after recovery. These models would be supported by evidence that depression alters levels of personality traits, either concurrently (concomitants model) or over the longer-term (consequences model).

Dynamic Models of Personality-Depression Relations

The models above consider traits to be perfectly stable. As noted earlier, there is now extensive evidence indicating that personality shows plasticity in childhood, with long-term test-retest correlations of r ≈ 0.35, and continues to change across the lifespan, although personality consistency gradually increases up to r ≈ 0.75 after the age of 50 ( Roberts & DelVecchio 2000 ). Models of personality-psychopathology relations can be expanded to recognize the malleability of traits (e.g., Ormel et al. 2001 ). For example, one can posit a dynamic precursor model 4 in which early temperament defines the baseline level of risk but subsequent experiences modify personality liability to depression. This model explains variability in disorder onset as a function of the initial level of risk and steepness of the trait trajectory over time. Given the evidence on patterns of personality continuity and change ( Roberts & DelVecchio 2000 ), it appears likely that trait vulnerability is more malleable early in life, but significant life events can alter its trajectory even in old age. A depressive disorder is thought to emerge when personality liability crosses the threshold. Thus, individuals who are born with an elevated personality liability or those with a rapidly increasing trait trajectory would have a childhood onset of the disorder, whereas those with a more slowly increasing trait trajectory would not cross the threshold until much later, if ever. Moreover, a pathological trait trajectory may be checked or reversed by positive experiences ( Ormel & de Jong 1999 ). In fact, personality generally tends to change in a more adaptive direction with age ( Roberts et al. 2006 ), although this pattern is not universal ( Johnson et al. 2007 ). This may help to explain why the probability of first-episode depression peaks in adolescence, as trait deviance is more common at that age.

Similarly, the predisposition model can be expanded to recognize personality change. This dynamic predisposition model ( Ormel & de Jong, 1999 , Ormel et al. 2001 ) acknowledges transactions between personality and the environment and integrates them with the environmental moderation and mediation mechanisms of the classic predisposition model. In the environmental moderation version of this account, negative life experiences influence not only depression onset but also levels of trait vulnerability ( Middledorp et al. 2008 ). This increase in personality liability may then lead to additional life stress. If this vicious cycle is perpetuated unchecked, personality liability would continue to increase, and at some point, a negative life event could overwhelm coping capabilities and elicit a depressive disorder. Importantly, and in contrast to the dynamic precursor model, in this account maladaptive traits alone are not sufficient to cause depression, and an environmental trigger is necessary.

The vicious cycle of increasing trait vulnerability and stress exposure does not necessarily indicate that personality per se influences depression onset. Indeed, certain traits may increase stress exposure but have no effect on depression otherwise (e.g., it is possible that low conscientiousness does not cause depression directly but leads to depressogenic experiences, such as academic difficulties, job loss, and relationship problems; Roberts et al. 2007 ), consistent with the environmental-mediation pathway.

Dynamic models offer richer and more complete accounts of the role of personality in the onset of depression. Moreover, it is important to recognize that depressive disorders have been linked to multiple traits (as reviewed below), and it is likely that different personality characteristics contribute through different pathways.

METHODOLOGICAL ISSUES

A number of methodological issues must be considered in evaluating the relation between personality and mood disorders, including ( a ) study design, ( b ) heterogeneity of depressive disorders, and ( c ) assessment of personality.

Study Design

A number of research designs can be useful in studying the relation between personality and depressive disorders. The common cause, continuum/spectrum, precursor, and predisposition models would all be supported by family studies demonstrating personality differences between nonaffected relatives of probands with and without a history of depression. The common cause, continuum/spectrum, and precursor models would be supported by twin and genetic association studies demonstrating that the same genes predispose to both personality and depressive disorders. The precursor and predisposition models posit that personality abnormalities are trait markers and hence should be present prior to the onset, and after recovery from, depressive episodes. Hence, these models can be tested by comparing individuals with a history of depression that is currently in remission to persons with no history of depression on relevant personality traits. An even stronger approach to testing the precursor and predisposition models is to use prospective longitudinal studies of persons with no prior history of mood disorder to determine whether particular personality traits predict the later onset of depressive disorder. Although no single design can distinguish among these four models, the combination of designs can bolster the case for particular accounts. For example, finding substantial common genetic variance in twin studies, but no evidence of developmental sequencing in longitudinal studies, would support the common cause and continuum/spectrum models. In turn, these two models could be compared by examining the specificity of the association between trait and disorder and whether there is a nonlinear relation between trait level and probability of disorder. On the other hand, if there were evidence of developmental sequencing in longitudinal studies as well as substantial common genetic variance in twin studies (or overlap of other etiological factors in other designs), it would support the precursor model (particularly if the trait was also phenomenologically similar to depression). In contrast, developmental sequencing but less shared genetic (or other etiological) variance would support the predisposition model. Also crucial for the predisposition model is evidence from longitudinal studies demonstrating that other variables (e.g., life stress) moderate or mediate the association between personality and subsequent depression.

The pathoplasticity model can be evaluated in longitudinal studies of persons with depressive disorders by examining the associations among personality traits and clinical features, course, and treatment response. Specifically, the pathoplasticity model posits that the trait would predict these outcomes even after controlling for initial illness severity and other prognostic factors. Of note, an alternative explanation of such results is that the personality trait is a marker for a more severe, chronic, or etiologically distinct subgroup, rather than having a causal influence on the expression of the disorder. A multiwave follow-up of individuals with a depressive disorder could be helpful in ruling out this possibility. If the trait influences the disorder course directly, rather than because it is an indicator of a latent disorder class, changes in personality scores should predict subsequent changes in outcomes.

The concomitants model can be tested through cross-sectional studies comparing persons who are currently depressed, persons who have recovered from depressive episodes, and healthy controls. An even better approach is to conduct longitudinal studies assessing individuals when they are in a depressive episode and again after they have recovered. If personality measures are abnormal during depressive episodes but not after recovery, it would suggest that they are concomitants of the depressed state. Multilevel analyses can also be used to separate personality variance into trait and state components and to test whether state variance is associated with concurrent measures of depression (e.g., Duncan-Jones et al. 1990 ).

The consequences (or scar) hypothesis can be evaluated by assessing persons before and after a first depressive episode. If personality deviance is much greater after the episode has remitted, it would suggest that scarring has occurred.

Testing dynamic theories requires longitudinal data with at least three assessment points. These assessments should measure relevant contextual factors (e.g., life stress) in addition to depression and personality to allow the examination of dynamic and transactional effects. Multilevel modeling and structural equation modeling offer powerful approaches to evaluating such effects with longitudinal data.

Heterogeneity of Depressive Disorders

The depressive disorders are almost certainly etiologically heterogeneous, reflecting the convergence of multiple developmental pathways. Hence, it is likely that the role of personality factors and, as suggested above, the applicability of different models of the relation between personality and depression differ for different forms of depression. The current classification system for depressive disorders is based on clinical features and is a poor approximation of etiological distinctions. Nonetheless, it is important to consider whether the role of personality varies as a function of the specific depressive diagnosis (e.g., major depressive disorder, dysthymic disorder), subtype (e.g., psychotic, melancholic, atypical), and clinical characteristics such as age of onset, recurrence, and chronicity. Failure to take heterogeneity into account may obscure important personality-depression associations. Conversely, personality may provide a basis for identifying more homogeneous subgroups within the depressive disorders. Unfortunately, few studies of personality and depressive disorders have attempted to take this heterogeneity into account.

It is important to note, however, that associations between personality and specific subtypes and clinical characteristics do not necessarily indicate etiological heterogeneity. Instead, they could reflect pathoplasticity, in which personality influences symptom presentation and/or course, but the primary etiological process is the same, or they could reflect differential severity of subtypes that results in quantitative differences in their trait profiles.

Finally, a significant source of heterogeneity in depression is comorbidity with other forms of psychopathology. Given the high rates of comorbidity, particularly with the anxiety disorders, associations between personality and depressive disorders may actually reflect the relation of personality with a co-occurring nonmood disorder. Indeed, personality may be a third variable that explains broad patterns of comorbidity among many disorders. For example, recent hierarchical models of classification posit that trait dispositions such as N/NE account for much of the comorbidity between depression and other disorders ( Griffith et al. 2010 , Kotov et al. 2007 ). Thus, it is important for researchers to consider whether traits have specific relations with depression over and above more general associations with the broader group of internalizing disorders.

Temperament/personality can be assessed using a variety of methods, including self-report inventories, semistructured interviews, informants’ reports, and observations in naturalistic settings and the laboratory. Unfortunately, most of the literature examining the association between personality and depressive disorders has assessed personality via self-report. This is potentially problematic because self-reports of personality can be complicated by current mood state, limited insight, response styles, and the difficulty of distinguishing traits from the effects of stable environmental contexts ( Chmielewski & Watson 2009 ). In addition, when the same individual provides information on both personality and depression, as has been the case in almost all studies in this area, common method variance can inflate associations. Hence, there is a need for greater use of informant report and observational measures.

A second issue concerns the overlap between some personality constructs and psychopathology ( Lahey 2004 ). For example, many items on N/NE scales are similar to depressive symptoms ( Ormel et al. 2004b ). This can inflate associations between measures of personality and depression. On the other hand, personality and symptom assessments usually have different time frames, with trait scales reflecting long-standing patterns and depression measures tapping more recent experiences (e.g., past week, past month). This trait versus state distinction parallels that between personality and other related constructs. For example, measures of N/NE and negative affect have nearly identical content but are distinguished by their time frames ( Watson 2000 ). Thus, the degree to which this content overlap threatens the validity of personality-psychopathology research depends, at least in part, on the duration/chronicity of the disorders of interest. The extent to which this is a concern also depends on one’s model of personality-depression relations. From the continuum/spectrum perspective, personality and depression are variants of the same phenomenon, so the two constructs should overlap. In contrast, the predisposition model views personality and depression as distinct domains, so from this perspective it is important to define and assess these sets of constructs as independently as possible and to judiciously delineate their time frames.

AFFECTIVE TEMPERAMENTS

The classical European descriptive psychopathologists in the late-nineteenth and early-twentieth centuries observed that many patients with mood disorders, as well as their relatives, exhibited particular patterns of premorbid personalities that appeared to be attenuated versions of their illnesses. For example, Kraepelin (1921) described four patterns of personality that he considered the “fundamental states” underlying manic-depressive illness: depressive, manic, irritable, and cyclothymic temperament. He believed that these were precursors or “rudimentary forms” of the major mood disorders. Schneider (1958) described similar types; however, he viewed them as personality disorders that were not necessarily related to the mood disorders. Two variants of these types, cyclothymic disorder and dysthymic disorder, are included as mood disorder diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; Am. Psychiatr. Assoc. 1994 ). However, these disorders are defined as fairly severe conditions, with the criteria emphasizing symptomatology rather than personality traits. As a result, these categories appear to be limited to the more severe, symptomatic manifestations of the affective temperaments described by Kraepelin and Schneider ( Akiskal 1989 ).

On the basis of Kraepelin’s and Schneider’s descriptions, Akiskal (1989) proposed formal criteria for the affective temperament types, and he and his colleagues developed interview and self-report measures of these constructs that have been applied in a number of settings and cultures (e.g., Akiskal et al. 2005 ). Akiskal’s work also provided the basis for including depressive temperament as a personality disorder in the DSM-IV appendix. Of the four affective temperament types, depressive temperament has been the most systematically studied in relation to nonbipolar depressive disorders. The terms “depressive temperament,” “depressive personality,” and “depressive personality disorder” have been used interchangeably in the literature to refer to the following constellation of traits: introversion, passivity, and nonassertiveness; gloominess, cheerlessness, and joylessness; self-reproach and self-criticism; pessimism, guilt, and remorse; being critical and judgmental of others; conscientiousness and self-discipline; brooding and given to worry; and feelings of inadequacy and low self-esteem.

Data on the nature of the relation between depressive personality and depressive disorders are consistent with most of the causal models described above, illustrating the complexity of the associations between personality and depression. The strongest support for the common cause and continuum/spectrum models derives from twin and family studies. In a large twin study, Ørstavik et al. (2007) found that depressive personality and major depressive disorder (MDD) shared substantial genetic variance, although there was evidence for unique genetic factors as well. Family studies indicate that individuals with depressive personality have an increased rate of mood disorders in their first-degree relatives (e.g., Klein & Miller 1993 ). In addition, patients with MDD, particularly those with chronic forms of depression, have elevated levels of depressive personality traits in their first-degree relatives ( Klein 1999 ).

Consistent with Kraepelin’s (1921) retrospective observations, prospective longitudinal data indicate that depressive personality traits precede the onset of depressive disorders. Kwon et al. (2000) found that young women with depressive personality and no comorbid Axis I and II disorders had a significantly increased risk of developing dysthymic disorder (but not MDD) over the course of a three-year follow-up. Taken together with the twin and family studies, these findings provide compelling support for the precursor model. In addition, in light of the conceptual issue regarding traits and states raised above for the continuum/spectrum and precursor models, it is noteworthy that depressive personality is most closely associated with chronic forms of depression at both the family and individual levels.

Evidence also supports the predisposition, pathoplasticity, and consequences models. Rudolph & Klein (2009) reported that youth with elevated levels of depressive personality traits experienced a significant increase in depressive symptoms 12 months later. While consistent with the precursor model, it is noteworthy that this association was moderated by pubertal status and timing. Thus, youth with elevated levels of depressive personality traits and more advanced pubertal status and earlier pubertal timing experienced the greatest increase in depressive symptoms. This supports the predisposition model, suggesting that depressive personality traits confer vulnerability to depression in the presence of other maturational and psychosocial processes.

Depressive personality also appears to have a pathoplastic effect on the course of depressive disorders, predicting poorer outcomes and response to treatment ( Laptook et al. 2006 , Ryder et al. 2010 ). Moreover, Rudolph & Klein (2009) recently reported preliminary support for the consequences model, at least in youth. They found that in a sample of early adolescents, higher levels of depressive symptoms predicted an increase in depressive personality traits 12 months later. Finally, the limited evidence available suggests that semi-structured interview assessments of depressive personality traits are not influenced by a depressive episode ( Klein 1990 ), arguing against the concomitants model.

Although the work on affective temperaments is important in understanding the development of depressive disorders, it is unlikely that these types actually reflect basic temperamental processes that originate in early childhood, as their defining features include a number of developmentally complex cognitive and interpersonal characteristics. Instead, these temperament types are more likely to be intermediate outcomes that reflect the interaction of more basic temperament traits that are elaborated over development in conjunction with early socialization and other environment influences.

In recent years, considerable evidence has accumulated indicating that depressive personality is associated with several of the basic personality trait dimensions discussed below, particularly high N/NE and low E/PE and a number of their facets (e.g., Huprich 2003 , Vachon et al. 2009 ).

PERSONALITY TRAIT DIMENSIONS

The affective temperaments are conceptualized within a categorical framework. In contrast, most of the other work on personality and depression views personality in dimensional terms. In this section, we focus on the FFM, but we also briefly consider Gray’s (1994) and Cloninger and colleagues’ (1993) psychobiological models and several additional traits from the clinical literature (e.g., self-criticism, dependency, and rumination). This section focuses primarily on studies of adults and adolescents using self-report measures of personality. Studies of younger children using observational measures of temperament are reviewed in a later section.

The Five-Factor Model

Cross-sectional associations.

In their influential theory of personality and depression, Clark & Watson (1999 , Clark et al. 1994 ) posited that depressive disorders are characterized by high levels of N/NE and low levels of E/PE. A large number of cross-sectional studies have evaluated these relations as well as the links between depression and the other FFM dimensions. Kotov et al. (2010) recently conducted a meta-analysis of this literature, which revealed that MDD is associated with very high N/NE (Cohen’s d =1.33) and low conscientiousness ( d =−0.90). The link to low E/PE was more modest ( d =−0.62) and inconsistent, with some studies finding positive effects. The associations with the other two traits were weak and unremarkable. The N/NE finding is consistent with expectations, but the effect for E/PE was smaller and that for conscientiousness was larger than anticipated. Dysthymic disorder exhibited a more extreme profile with remarkably strong and consistent links to E/PE ( d =−1.47), N/NE ( d =1.93), and conscientiousness ( d =−1.24). This is not surprising as dysthymic disorder is thought to be more trait-like than MDD, and a greater contribution from personality might be expected.

To determine whether the observed personality links are specific to depression, Kotov et al. (2010) also examined personality profiles of anxiety disorders. They found that with the exception of specific phobia, which had relatively weak associations with all five traits, all anxiety disorders showed stronger effects on N/NE, E/PE, and conscientiousness (average d =1.91, −1.05, −1.02, respectively) than did MDD. Several also scored above dysthymic disorder on N/NE. Dysthymia had stronger associations than anxiety disorders on the other two traits, but the differences were slight.

It is conceivable that more specific associations were not evident because these analyses focused on broad personality dimensions. Narrow traits that comprise the general dimensions may have stronger associations with depressive disorders. Indeed, self-harm—a component of N/NE that reflects propensity to self-deprecation and self-injury—was found to contribute to depression even after controlling for the broad traits, and this effect was specific relative to other common mental disorders ( Watson et al. 2006 ). With regard to E/PE, evidence is emerging that the positive affectivity facet, but not the sociability/extraversion facet, is related to depression ( Durbin et al. 2005 , Naragon-Gainey et al. 2009 ). This may explain the surprisingly modest association between MDD and E/PE, if this general trait includes much variance not relevant to depression. Thus, facet-level research promises to yield stronger and more specific evidence of personality-depression links.

Evidence bearing on causal models

Because most attempts to tease apart explanatory models of the association between depression and personality have focused on N/NE and E/PE, we consider only these two traits in this section. The section is organized by the type of research design used to address the models.

Personality during and after a depressive episode

Studies of personality and psychopathology may be complicated by the influence of participants’ mood states on reports of their personalities (the concomitants model). For example, many studies have found that individuals with MDD report higher levels of N/NE when they are depressed than when they are not depressed ( Hirschfeld et al. 1983b , Kendler et al. 1993 , Ormel et al. 2004a ). In contrast, the evidence for mood state effects on E/PE is weaker and less consistent ( de Fruyt et al. 2006 , Kendler et al. 1993 , Morey et al. 2010 ). However, the influence of mood state on personality should not be overstated. Even though levels of N/NE decline significantly after remission from a depressive episode (i.e., absolute stability), individuals’ relative positions with respect to levels of N/NE (i.e., rank-order stability) tend to be moderately well preserved ( de Fruyt et al. 2006 , Morey et al. 2010 ). Moreover, clinical trials suggest that changes in depressive symptoms are not necessarily accompanied by changes in personality ( Quilty et al. 2008b , Tang et al. 2009 ).

Cross-sectional comparisons of remitted patients and controls

A number of early studies used remission designs, comparing patients who had recovered from a depressive episode to never-depressed controls or population norms on self-rated personality traits. These studies found that E/PE is significantly lower in formerly depressed patients than in healthy controls ( Hirschfeld et al. 1983a , Reich et al. 1987 ), arguing against the concomitants model and in favor of the precursor, predisposition, and/or consequences models. However, the results for N/NE were less consistent ( Hirschfeld et al. 1983a , Reich et al. 1987 ). This inconsistency may be due to a number of factors, including insufficiently stringent criteria for recovery, thereby possibly confounding personality and residual symptoms; using normative data collected by other investigators, which may introduce demographic and sociocultural differences between the formerly depressed and comparison samples; and selection effects, as N/NE is associated with a poorer course (discussed below) and thus samples of remitted depressives may include a disproportionate number with low levels of this trait.

Personality before and after a depressive episode

Several studies have tested the consequences (or scar) hypothesis by comparing personality measures in depressed individuals before and after a MDD episode. The results of these studies have been inconsistent. Kendler and colleagues reported increases in N/NE (but not E/PE) after a depressive episode in two separate samples ( Fanous et al. 2007 , Kendler et al. 1993 ); however, other studies have found that N/NE and E/PE do not change from before to after a MDD episode (e.g., Ormel et al. 2004a , Shea et al. 1996 ). Importantly, the studies reporting scarring used less stringent criteria for recovery and shorter follow-ups, suggesting that the findings may be due to residual symptoms and/or that the scars dissipate over time.

Personality in relatives of depressed individuals

A number of studies have tested the common cause, continuum/spectrum, precursor, and predisposition models by comparing personality traits in the never-depressed relatives of patients with mood disorders and never-depressed controls (e.g., Farmer et al. 2002 , Hecht et al. 1998 , Ouimette et al. 1996 ). The results have been mixed, with some studies reporting higher N/NE and/or lower E/PE in the never-depressed relatives of probands with mood disorders, and other studies reporting no differences. However, interpretation of these studies is complicated by two factors. First, personality traits may not play the same role in risk for depression among familial as nonfamilial forms of depression. Second, there may be selection biases in samples using well relatives who are already partly through the risk period for mood disorder. Thus, those relatives with the strongest personality vulnerabilities may have already developed the disorder and be excluded from the study.

Twin studies

As discussed above, a valuable approach to testing the common cause, continuum/spectrum, and precursor models is through twin studies. These studies indicate that there are substantial associations between the liabilities for N/NE and MDD, but only weak associations between the genetic liabilities for E/PE and MDD ( Fanous et al. 2007 ; Kendler et al. 1993 , 2006 ).

Prospective longitudinal studies

The most direct approach to testing the precursor and predisposition models is to conduct prospective studies of personality in never-depressed participants to determine whether personality characteristics predict the subsequent onset of depressive disorders. Several studies using large community samples have reported that higher levels of N/NE predict the onset of first lifetime MDD episodes ( de Graaf et al. 2002 ; Fanous et al. 2007 ; Kendler et al. 1993 , 2006 ; Ormel et al. 2004a ). In addition, several studies using measures of other traits that overlap with N/NE or its facets have reported similar findings ( Hirschfeld et al. 1989 , Rorsman et al. 1993 ). Although there is some evidence that E/PE predicts the first onset of MDD ( Kendler et al. 2006 , Rorsman et al. 1993 ), it is much weaker, and several studies have failed to find an association ( Fanous et al. 2007 , Hirschfeld et al. 1989 , Kendler et al. 1993 ).

Personality and the subsequent course of depression

Finally, there is evidence that both N/NE and E/PE have pathoplastic influences on the course of depression after the onset of the disorder. For example, many studies have reported that higher N/NE and lower E/PE predict a poorer course and response to treatment, although the findings regarding E/PE are slightly less consistent ( de Fruyt et al. 2006 , Duggan et al. 1990 , Morris et al. 2009 , Quilty et al. 2008a , Tang et al. 2009 ). As noted above, however, these findings are also consistent with diagnostic heterogeneity, such that personality dysfunction is a marker for a more severe or etiologically distinct group. Indeed, there is evidence that the nonmelancholic subtype is characterized by more vulnerable personality styles than is melancholia and that chronic depressions are associated with higher N/NE and lower E/PE than is nonchronic MDD ( Klein 2008 , Kotov et al. 2010 ).

Evidence relevant to dynamic models

Transactions between N/NE and environmental contexts have received the most attention in the literature ( Ormel & de Jong 1999 , van Os & Jones 1999 ). N/NE shows reciprocal relations with a range of significant life experiences, such as initiation and break-up of a committed relationship, relationship quality, occupational attainment, and financial security ( Neyer & Lehnart 2007 , Roberts et al. 2003 , Scollon & Diener 2006 ). Furthermore, N/NE has been repeatedly implicated in the generation of stressful life events ( Kercher et al. 2009 , Lahey 2009 , Middeldorp et al. 2008), which suggests an environmentally mediated relationship between this trait and depression. The environmentally moderated mechanism has also received support, as several studies found that N/NE interacts with stressful life events to predict first onset of major depression ( Kendler et al. 2004 , Ormel et al. 2001 , van Os & Jones 1999 ).

E/PE has demonstrated bidirectional effects with many significant social and occupational experiences ( Neyer & Lehnart 2007 , Roberts et al. 2003 , Scollon & Diener 2006 ). In addition, a decrease in E/PE over time was found to predict future internalizing problems ( Van den Akker et al. 2010 ). However, little attention has been given to mechanisms underlying the association between this trait and depression. Support for an environmentally mediated effect is limited and mixed (Middeldorp et al. 2008, Wetter & Hankin 2009 ), and the environmental moderation model is largely untested, although there is some evidence that positive affect moderates the effects of daily stressors on depressive symptoms ( Wichers et al. 2007 ).

Finally, conscientiousness may play an important role in dynamic models of personality-depression relations. It has reciprocal associations with family support, divorce, occupational attainment, and job involvement ( Roberts et al. 2003 , Roberts & Bogg 2004 ). Conscientiousness is hypothesized to influence depression by increasing exposure to negative life events ( Anderson & McLean 1997 , Compas et al. 2004 ), but mediation and moderation effects have not been tested.

Interactions between temperament dimensions

Finally, personality-depression relations may be multivariate, rather than bivariate, with multiple traits interacting to influence depression. Indeed, in their influential model of personality and depression, Clark & Watson (1999 , Clark et al. 1994 ) hypothesized that depression is characterized by high N/NE and low E/PE, raising the possibility that it is the combination of the two traits that is particularly important in depressive disorders. A growing number of studies have reported that the interaction of high N/NE and low E/PE predicts subsequent depressive symptoms or disorders in adults and youth ( Gershuny & Sher 1998 , Joiner & Lonigan 2000 , Wetter & Hankin 2009 ), although several studies have not found such an interaction ( Jorm et al. 2000 , Kendler et al. 2006 , Verstraeten et al. 2009 ). The interaction between N/NE and conscientiousness is also of interest, as the latter construct includes aspects of self-regulation and effortful control ( Rothbart & Bates 2006 ) and may therefore reflect the ability to modulate one’s affective reactivity. Indeed, there is cross-sectional evidence that effortful control moderates the association between N/NE and depressive symptoms in adolescents ( Verstraeten et al. 2009 ).

Summary and discussion

Cross-sectional studies have documented strong links of depressive disorders to N/NE, conscientiousness, and E/PE, although the latter effect is substantial in dysthymic disorder but only moderate in MDD. In fact, personality generally appears to play a greater role in dysthymia. None of these relations are specific, however, as anxiety disorders have very similar trait profiles. This observation argues against the continuum/spectrum model at least with regard to these broad dimensions. It may be possible to find traits that are specific to depression by targeting lower-order personality dimensions. Narrower traits may also explain the surprisingly modest link between E/PE and MDD, as some, but not other, facets of this general dimension are relevant to depression.

The nature of relations between these personality traits and depression is complex, and our understanding is still limited. N/NE, the most widely studied personality trait in depression, raises challenging conceptual and methodological issues due to the overlap between some of its features and depressive symptoms ( Ormel et al. 2004b ). Nonetheless, this cannot completely explain the association between these constructs ( Tang et al. 2009 ). N/NE is moderately influenced by clinical state (the concomitants model), shares common etiological influences with MDD (common cause, continuum/spectrum, and precursor models), predicts the subsequent onset of MDD (precursor and predisposition models), and influences the course of depression (pathoplasticity model). In addition, N/NE appears to contribute to subsequent stress and adversity and increases the risk of depression in the face of negative life events (predisposition model). Finally, it may also be changed by experience of MDD episodes (consequences model), but the evidence for this is weaker and less consistent.

The role played by E/PE in depression is less clear. Its cross-sectional association with dysthymia is substantial, but its relation to MDD is more modest. E/PE is not influenced by clinical state or changed by the experience of depressive episodes. It appears to be abnormally low even during remission, which is consistent with the continuation of trait deviance from the pre-morbid stage (precursor or predisposition accounts). Moreover, low E/PE tends to predict a poorer course of depression. However, the degree of shared etiological influences between E/PE and MDD is low, and the evidence that E/PE predicts the onset of MDD in prospective longitudinal studies is weak. As noted above, three possible reasons for the weaker and less consistent findings regarding E/PE are ( a )it plays a greater role in some forms of depression than others (e.g., chronic depressions); ( b ) only some facets of the broader trait (e.g., low positive affective and approach motivation) are related to depression; and ( c ) E/PE may make a greater contribution to depression by moderating N/NE than as a main effect ( Olino et al. 2010 ).

Finally, there appears to be a strong negative association between conscientiousness and depression, at least in cross-sectional studies. This may appear surprising in light of the positive associations discussed below between depression and a number of other constructs that are thought to be related to conscientiousness, such as behavioral inhibition system sensitivity, harm avoidance, perfectionism, and temperamental behavioral inhibition. It is important to note, however, that these latter constructs are more strongly associated with high N/NE, and in some cases, low E/PE, than with conscientiousness ( de Fruyt et al. 2000 , Muris et al. 2009a , Smits & Boeck 2006 ). Hence, it is likely that their positive correlations with depression are driven by their shared variance with high N/NE. Unfortunately, few studies testing causal models of personality and depression have considered conscientiousness. However, evidence indicating that this trait may moderate the effects of N/NE on depression and that it increases the likelihood of subsequent adversity that could then, in turn, produce depression suggests that further research on the role of conscientiousness is warranted.

Psychobiological Models

Gray’s model.

Gray’s (e.g., Gray 1994 ) influential theory proposes that there are two major neurobehavioral systems that underlie behavior: the behavioral activation system (BAS), which responds to signals of reward, and the behavioral inhibition system (BIS), which is sensitive to cues for punishment. Although BAS and BIS differ conceptually and empirically from E/PE and N/NE, their relations with depression are thought to be similar. Thus, it has been hypothesized that depression is associated with reduced BAS and/or heightened BIS sensitivity ( Depue & Iacono 1989 , Gray 1994 ). Although much of this work has focused on bipolar disorder (e.g., Alloy et al. 2008 , Johnson et al. 2008 ), several recent studies have examined self-report measures of BAS and BIS sensitivity in MDD. Consistent with Gray’s model, compared with healthy controls, currently depressed patients report lower levels of BAS and higher levels of BIS, and patients with a past history of MDD report lower levels of BAS ( Pinto-Meza et al. 2006 ). In addition, lower BAS sensitivity, but not higher BIS sensitivity, is associated with a poorer course of MDD (e.g., Kasch et al. 2002 , McFarland et al. 2006 ), suggesting that BAS may have a pathoplastic effect on depression.

Cloninger’s model

Cloninger (e.g., Cloninger et al. 1993 ) has proposed a model of personality that includes four temperament and three character dimensions. The temperament dimensions include novelty seeking (an appetitive/approach system), harm avoidance (an inhibition/avoidance system), reward dependency (a system that is responsive to signals of social approval and attachment), and persistence. The character dimensions are self-directedness (responsible, goal-directed), cooperativeness (helpful, empathic versus hostile and alienated), and self-transcendence (imaginative, unconventional). Harm avoidance is conceptually and empirically associated with BIS, and novelty seeking and persistence are associated with BAS. Similarly, harm avoidance is positively correlated with N/NE and negatively associated with E/PE, self-directedness is negatively correlated with N/NE, and novelty seeking and persistence are associated with E/PE (e.g., de Fruyt et al. 2000 ).

A number of studies have reported that patients with MDD report higher levels of harm avoidance and lower levels of self-directedness than do healthy controls (e.g., Celikel et al. 2009 ). Most of the traits in Cloninger’s system are influenced by the respondent’s mood state (e.g., Farmer et al. 2003 ); however, abnormal levels of harm avoidance and self-directedness are present even after remission (e.g., Smith et al. 2005 ). Increased harm avoidance and lower self-directedness are also characteristic of most anxiety disorders, indicating that these effects are not specific to MDD ( Öngür et al. 2005 ).

Few studies have explicitly tested the common cause, precursor, predisposition, and consequences hypotheses for Cloninger’s model. Farmer et al. (2003) found that the never-depressed siblings of patients with MDD reported significantly greater harm avoidance and less self-directedness than did the never-depressed siblings of healthy controls. In addition, Cloninger et al. (2006) reported that in a large community sample, high harm avoidance and persistence and low self-directedness predicted an increase in self-reported depressive symptoms 12 months later. A larger number of studies have addressed the pathoplasticity hypothesis, albeit with mixed results. Low harm avoidance, self-directedness, and reward dependency have predicted a poorer response to treatment in some, but not all, studies; the other dimensions have generally not been associated with course and treatment outcome ( Joyce et al. 2007 , Kennedy et al. 2005 , Morris et al. 2009 ).

Clinical Traits

Independent of the traditional personality field, clinical researchers have developed a number of trait-like constructs to describe dispositions to depression. These clinical traits are similar in scope to personality facets, and their stability is comparable to that of a typical personality dimension (e.g., Kasch et al. 2001 , Zuroff et al. 2004 ). Also, factor analytic studies have shown that most of these clinical traits can be successfully incorporated in the personality taxonomy as components of neuroticism ( Watson et al. 2006 ). Next, we briefly discuss three of the most studied constructs: ruminative response style, self-criticism, and dependency.

Ruminative response style, a tendency to dwell on sad mood and thoughts ( Nolen-Hoeksema 1991 ), is correlated with concurrent depressive symptoms and predicts future symptoms as well as increases in symptoms over time ( Rood et al. 2009 ). Also, one study reported that ruminative response style prospectively predicts onset of MDD ( Nolen-Hoeksema 2000 ). The trait has also been linked to anxiety disorders, but the association with depression is appreciably stronger ( Cox et al. 2001 , Nolen-Hoeksema et al. 2008 ).

Blatt’s (1974 , 1991 ) theory of depression focuses on two trait vulnerabilities: self-criticism (an inclination to feelings of guilt and failure stemming from unrealistically high expectations for oneself) and dependency (a disposition to feelings of helplessness and fears of abandonment resulting from a preoccupation with relationships). These constructs are similar, although not identical, to Beck’s (1983) constructs of autonomy and sociotropy. Studies indicate that the link between dependency and depressive disorders is relatively weak and nonspecific, whereas self-criticism has been established as an important and specific factor in these conditions ( Zuroff et al. 2004 ). Both traits have been conceptualized as dynamic predispositions to depressive disorders, and there is some support for this view, including evidence of transactions with life stress as well as environmental mediation and moderation of personality effects ( Zuroff et al. 2004 ). Self-criticism, and to a lesser extent dependency, have also been found to predict future increases in depressive symptoms. In addition, there is evidence that dependency predicts the subsequent onset of major depression in older, but not younger, individuals ( Hirschfeld et al. 1989 , Rohde et al. 1990 ). The concomitants and pathoplasty models have also received empirical support ( Zuroff et al. 2004 ). Finally, there is some research indicating that dependency may increase as a function of depressive episodes (consequences model) in youth but not adults ( Rohde et al. 1990 , 1994 ; Shea et al. 1996 ).

As noted above, all of these constructs are strongly linked to N/NE ( Cox et al. 2001 , Kasch et al. 2001 ), and some (particularly rumination and self-criticism) can be considered facets of this broader trait ( Watson et al. 2006 ). Lower-order facets can account for variance over and above that of higher-order traits ( Paunonen & Ashton 2001 ), and several cross-sectional studies have supported the incremental validity of ruminative response style and self-criticism ( Cox et al. 2004 , Muris et al. 2009b ) in associations with depressive symptoms. However, this issue requires more research, particularly using longitudinal designs.

CHILD TEMPERAMENT

Most of the literature on personality and depression has focused on adolescents and adults. Research that is grounded in the child temperament literature in developmental psychology has the potential to extend existing work on personality in depression by ( a ) providing the strongest test of the precursor and predisposition models; ( b ) more precisely delineating the behavioral manifestations of temperamental vulnerabilities to mood disorders in young children; ( c ) tracing the development and continuity of trait vulnerabilities across the lifespan; and ( d ) examining the neurobiological, cognitive, and interpersonal processes that may mediate the association between early temperament traits and the subsequent development of depressive disorder ( Compas et al. 2004 , Klein et al. 2008a , Kovacs & Lopez-Duran 2010 ).

The early childhood temperament dimensions that have received the greatest attention with respect to depression are N/NE, E/PE, and behavioral inhibition (BI). BI refers to wariness, fear, and low exploration in novel situations ( Kagan et al. 1987 ). It combines aspects of N/NE (fear and anxiety), E/PE (low approach), and conscientiousness (constraint/ effortful control) that do not have a direct analog in most models of adult personality.

Cross-sectional and longitudinal studies of older children and adolescents using self-report measures have generally reported associations of low E/PE and high N/NE with depression similar to those in the adult literature (e.g., Lonigan et al. 2003 ). 5 Observational studies of younger children of depressed mothers also indicate that these traits may be associated with risk for depression ( Kovacs & Lopez-Duran 2010 ). For example, in a community sample of 100 three-year-olds, Durbin et al. (2005) reported that children of mothers with a history of mood disorder exhibited low PE in emotion-eliciting laboratory tasks. Importantly, this effect was limited to the affective (positive affect) and motivational (approach/engagement), rather than the interpersonal (sociability), components of PE. Furthermore, low PE at age 3 predicted depressotypic cognition and memory biases at age 7 ( Hayden et al. 2006 ) and parent-reported depressive symptoms at age 10 ( Dougherty et al. 2010 ).

Subsequently, using a larger community sample (N = 543), Olino et al. (2010) found that preschool-aged children of parents with a history of depression had higher levels of NE and BI. However, both main effects were qualified by interactions with child PE. At high and moderate (but not low) levels of child PE, higher levels of NE and BI were each associated with higher rates of parental depression. Conversely, at low (but not high and moderate) levels of child NE, low PE was associated with higher rates of parental depression. Taken together, these results suggest that children of depressed parents may exhibit diminished PE or elevated NE and BI. In this latter sample, low PE was also associated with elevated levels of cortisol shortly after awakening, an index of hypothalamic-pituitary-adrenal axis dysregulation that has been shown to predict MDD in adolescents and adults ( Dougherty et al. 2009 ).

In both the Durbin et al. (2005) and Olino et al. (2010) studies, the child temperament–parental psychopathology associations were specific to depression. However, other work suggests that children of parents with anxiety disorders may also exhibit elevated BI. For example, Rosenbaum et al. (2000) assessed BI using laboratory measures in 2-to 6-year-old children of parents with a history of MDD and/or panic disorder and parents with no history of mood or anxiety disorders. Children of patients with both MDD and panic disorder exhibited significantly greater BI than did children of parents with no history of mood or anxiety disorder. Children of parents with panic disorder alone and children of parents with MDD alone had intermediate levels of BI that did not differ significantly from children of parents in the comorbid and no-psychopathology groups.

Finally, there is some direct evidence that personality traits assessed in childhood predict the development of depressive disorders in adults. Caspi et al. (1996) reported that children who were rated as socially reticent, inhibited, and easily upset at age 3 had elevated rates of depressive (but not anxiety or substance use) disorders at age 21. Moreover, van Os et al. (1997) found that physicians’ ratings of behavioral apathy at ages 6, 7, and 11 were predictive of both adolescent mood disorder and chronic depression in middle adulthood. However, BI appears to predict the development of anxiety disorders at least as strongly as depression ( Hirshfeld-Becker et al. 2008 ).

CLINICAL IMPLICATIONS

Personality research has important implications for the prevention of depression. Meta-analytic evidence indicates that existing preventive interventions can reduce the incidence of depressive disorders by 25% ( Cuijpers et al. 2008 ). However, the available strategies are a mix of universal (intervention is administered to the entire population), selective (to a well-defined at-risk group), and indicated (to those with subthreshold disorder) approaches. Universal interventions are costly, lack a personalized focus, and require very large samples to yield detectable effects, whereas indicated interventions may be better described as treatment than prevention ( Muñoz et al. 2010 ). In contrast, selective interventions are true preventive measures that are cost effective and can be tailored to a specific mechanism of risk. However, implementation of selective strategies requires knowledge of risk factors and causal processes that lead from the vulnerability to the disorder.

The majority of established risk factors for depressive disorders are either immutable (e.g., demographic characteristics, family history) or predict onset only in the short term (e.g., stressful life events). In contrast, personality is at least somewhat malleable, especially in youth, but may forecast the onset of depression years in advance, which makes traits a potentially attractive means of identifying individuals at risk and informing selection of interventions. Different trait-disorder pathways would point to different preventive strategies; hence, further research on the nature of personality-depression relations can significantly facilitate development of preventive interventions. Another advantage of traits is that they can be assessed relatively easily and efficiently and thus are ideal for screening.

Treatment Response

Personality also can inform treatment of depressive disorders post onset. In particular, traits can predict response to treatment. Substantial evidence has accumulated that individuals with lower N/NE have better treatment outcomes across modalities ( Kennedy et al. 2005 , Mulder 2002 , Tang et al. 2009 ). Other Big Five traits have been studied less and their role is not yet certain. However, a recent large investigation of a combination intervention (medication plus psychotherapy) found that low N/NE and high conscientiousness predicted who would respond to treatment, and although high E/PE did not contribute directly, it amplified the effect of high conscientiousness ( Quilty et al. 2008a ). As discussed above, investigations of Cloninger’s traits have produced inconsistent results ( Joyce et al. 2007 , Kennedy et al. 2005 , Mulder 2002 ). Few studies have examined personality facets, but preliminary evidence suggests that lower-order traits can add substantially to the prediction of treatment response ( Bagby et al. 2008 ). Among clinical traits, self-criticism, but not dependency, was found to forecast poor treatment outcomes ( Blatt et al. 1995 ). Furthermore, personality may be useful in matching patients to interventions. For instance, Bagby et al. (2008) reported that patients high on N/NE or low on some agreeableness facets respond better to antidepressant medication than to psychotherapy.

The processes underlying these predictive associations are not entirely clear. One hypothesis is that personality change mediates the effect of treatment on depression. Indeed, there is a fair amount of evidence that depression treatment reduces N/NE and increases E/PE ( Zinbarg et al. 2008 ) and that this effect is not due to confounding by the depressive state ( Tang et al. 2009 ). Quilty et al. (2008b) tested a mediation model and found direct support for this hypothesis. Other possibilities need to be ruled out, however, particularly the hypotheses that traits predict poorer response because they indicate a more severe form of depression or that they interfere with treatment compliance and the therapeutic relationship, thus reducing the efficacy of the intervention.

CONCLUSIONS AND FUTURE DIRECTIONS

The literature on the relation between personality and depression is large, but it has many gaps and inconsistent findings. Nonetheless, it is possible to draw a number of conclusions. First, there are moderate-to-large cross-sectional associations between depression and three general personality traits—N/NE, E/PE, and conscientiousness—as well as with a variety of related traits (e.g., harm avoidance, rumination, and self-criticism) and personality types (depressive personality). Second, most of the personality traits associated with depression also are related to other forms of psychopathology, particularly anxiety disorders. This may reflect the phenomenon of multifinality, in which variables early in the causal chain lead to multiple outcomes depending on subsequent events in the causal pathway. On the other hand, many of the disorders that are currently classified as distinct conditions are closely related; hence, research on personality-psychopathology associations can provide important information for revising our nosological system. Third, reports of some traits (e.g., N/NE and harm avoidance) are influenced by clinical state, whereas other traits (e.g., E/PE) appear to be independent of mood state. However, state effects cannot fully account for the associations between personality and depression. Fourth, shared etiological factors (e.g., genes) account for a portion of the association between N/NE and depression. Fifth, depressive personality and some traits, particularly N/NE, predict the subsequent onset of depressive disorders. However, it is unclear at this point whether they are best conceptualized as precursors or predispositions, as it is difficult to tease these models apart, and there is evidence supporting both accounts. In either case, there is growing evidence that temperamental risk factors are evident at an early age, suggesting a promising approach to identifying young children at risk for depression. Sixth, there is evidence suggesting that other traits, such as low E/PE and low conscientiousness/effortful control, may moderate the relationship between N/NE and depression. Seventh, it appears unlikely that depressive episodes produce enduring changes in most personality traits. Finally, personality traits predict, and may in fact influence, the course and treatment response of depression.

To make further progress in elucidating the relation between personality and mood disorders, future studies should be guided by six broad considerations. First, most of the literature on personality and depression has focused on the broad traits of N/NE and E/PE. There is a need for further work on conscientiousness and on lower levels in the trait hierarchy (i.e., facets). It is important to determine whether a more specific level of analysis will yield more powerful effects and increase the specificity of associations between personality constructs and particular forms of psychopathology. Clinical traits, such as ruminative response style and self-criticism, need to be included in these studies and evaluated jointly with traditional personality dimensions. Finally, it is important to continue to explore interactions between traits.

Second, there is a critical need for prospective, longitudinal studies. Most existing longitudinal studies have begun in late adolescence or adulthood. However, a substantial proportion of mood disorders have already developed by mid-adolescence. Therefore, in order to further test the precursor and predisposition models, and to trace the developmental pathways between personality and depression, it is necessary to conduct longitudinal studies that start as early as possible in order to obtain a sufficient number of first-onset cases and avoid selection biases caused by excluding participants who already have a history of mood disorder at initial assessment.

Third, depression researchers have treated personality as static. However, personality changes over the course of development. Future work must begin to consider the complex personality-environment transactions that can strengthen or attenuate personality trajectories and predispositions for depressive disorder. In addition, as understanding of epigenetics increases, it will be important to explore epigenetic influences on personality change and their relation to depression.

Fourth, if personality is a precursor of, or predisposes to, the development of depressive disorders, it is critical to identify the moderating factors and mediating processes involved in these pathways. There is some evidence suggesting that moderators may include gender, early adversity, and life stress, and mediators may include interpersonal deficits, depressotypic cognitions, maladaptive coping, and behavioral and neurobiological stress reactivity ( Klein et al. 2008a ). There is a need for more systematic research examining these moderators and mediators in a longitudinal framework.

Fifth, self-reports have borne the brunt of most research in this area and have made important contributions. However, like all methods, they have limitations and cannot be applied in all contexts (e.g., young children). Thus, there is a need for further work using complementary methods such as informant reports and observations in naturalistic and laboratory settings.

Finally, the role of personality/temperament may differ for different forms of depressive disorder. Personality appears to play an especially important role in early-onset, chronic, and recurrent depressive conditions (e.g., Klein 2008 , Kotov et al. 2010 , van Os et al. 1997 ). Focusing on broad diagnostic categories such as MDD may obscure important associations with particular forms of depression; hence, future studies need to give greater consideration to the heterogeneity of depressive disorders.

SUMMARY POINTS

• There are moderate-to-large cross-sectional associations between depression and three general personality traits—N/NE, E/PE, and conscientiousness—as well as with a variety of related traits (e.g., harm avoidance, rumination, and self-criticism) and personality types (e.g., depressive personality).
• Most of the personality traits associated with depression also are related to other forms of psychopathology, particularly anxiety disorders. This may reflect the phenomenon of multifinality, in which variables early in the causal chain lead to multiple outcomes depending on subsequent events in the causal pathway. On the other hand, many of the disorders that are currently classified as distinct conditions are closely related; hence, research on personality-psychopathology associations can also provide important information for revising our nosological system.
• Reports of some traits (e.g., N/NE and harm avoidance) are influenced by clinical state, whereas other traits (e.g., E/PE) appear to be independent of mood state. However, state effects cannot fully account for the associations between personality and depression.
• Shared etiological factors (e.g., genes) account for a portion of the association between N/NE and depression.
• Depressive personality and some traits, particularly N/NE, predict the subsequent onset of depressive disorders. However, it is unclear at this point whether they are best conceptualized as precursors or predispositions, as it is difficult to tease these models apart, and there is evidence supporting both accounts. In either case, there is growing evidence that temperamental risk factors are evident at an early age, suggesting a promising approach to identifying young children at risk for depression.
• There is evidence suggesting that other traits, such as low E/PE and low conscientiousness/effortful control, may moderate the relationship between N/NE and depression.
• It appears unlikely that depressive episodes produce enduring changes in most personality traits.
• Personality traits predict, and may in fact influence, the course and treatment response of depression.

1 There may not be complete specificity owing to diagnostic heterogeneity. As discussed below, depression is a heterogeneous disorder with multiple etiological pathways (equifinality). A personality trait may be part of only one of the pathways. In contrast, multifinality, in which the trait is associated with multiple disorders, is less consistent with the continuum/spectrum view.

2 Application of the continuum/spectrum and precursor models to depressive disorders is not straightforward. Personality traits are relatively stable, whereas depression is often episodic. Existing formulations of the continuum/spectrum model have not explained how stable trait characteristics manifest as an episodic illness. Similarly, the precursor model does not account for why a stable trait would subsequently develop into a nonstable depressive state. Thus, the continuum/spectrum and precursor models may provide a better explanation for chronic than episodic forms of depression.

3 Although moderating and mediating variables play an explicit and central role in the predisposition model, it should be acknowledged that they are not incompatible with the precursor account. That is, the escalation from personality traits to depressive disorders in the precursor model implies that additional variables (e.g., maturational or environmental factors) must be involved to precipitate the change.

4 This could also be called the dynamic continuum model because once the dynamic element is introduced, it becomes virtually impossible to distinguish the continuum/spectrum and precursor models.

5 Few studies have examined the association of conscientiousness/effortful control with depression in youth, but analogous to the adult literature, there is cross-sectional evidence that effortful control is negatively correlated with depression ( Verstraeten et al. 2009 ).

DISCLOSURE STATEMENT

The authors are not aware of any affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review.

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434 Depression Essay Titles & Research Topics: Argumentative, Controversial, and More

Depression is undeniably one of the most prevalent mental health conditions globally, affecting approximately 5% of adults worldwide. It often manifests as intense feelings of hopelessness, sadness, and a loss of interest in previously enjoyable activities. Many also experience physical symptoms like fatigue, sleep disturbances, and appetite changes. Recognizing and addressing this mental disorder is extremely important to save lives and treat the condition.

In this article, we’ll discuss how to write an essay about depression and introduce depression essay topics and research titles for students that may be inspirational.

• 🔝 Top Depression Essay Titles
• ✅ Essay Prompts
• 💡 Research Topics
• 🔎 Essay Titles
• 💭 Speech Topics
• 📝 Essay Structure

🔗 References

🔝 top 12 research titles about depression.

• How is depression treated?
• Depression: Risk factors.
• The symptoms of depression.
• What types of depression exist?
• Depression in young people.
• Differences between anxiety and depression.
• The parents’ role in depression therapy.
• Drugs as the root cause of depression.
• Dangerous consequences of untreated depression.
• Effect of long-term depression.
• Different stages of depression.
• Treatment for depression.

✅ Prompts for Essay about Depression

Struggling to find inspiration for your essay? Look no further! We’ve put together some valuable essay prompts on depression just for you!

Prompt for Personal Essay about Depression

Sharing your own experience with depression in a paper can be a good idea. Others may feel more motivated to overcome their situation after reading your story. You can also share valuable advice by discussing things or methods that have personally helped you deal with the condition.

For example, in your essay about depression, you can:

• Tell about the time you felt anxious, hopeless, or depressed;
• Express your opinion on depression based on the experiences from your life;
• Suggest a way of dealing with the initial symptoms of depression ;
• Share your ideas on how to protect mental health at a young age.

How to Overcome Depression: Essay Prompt

Sadness is a common human emotion, but depression encompasses more than just sadness. As reported by the National Institute of Mental Health, around 21 million adults in the United States, roughly 8.4% of the total adult population , faced at least one significant episode of depression in 2020. When crafting your essay about overcoming depression, consider exploring the following aspects:

• Depression in young people and adolescents;
• The main causes of depression;
• The symptoms of depression;
• Ways to treat depression;
• Help from a psychologist (cognitive behavioral therapy or interpersonal therapy ).

Postpartum Depression: Essay Prompt

The birth of a child often evokes a spectrum of powerful emotions, spanning from exhilaration and happiness to apprehension and unease. It can also trigger the onset of depression. Following childbirth, many new mothers experience postpartum “baby blues,” marked by shifts in mood, bouts of tears, anxiety, and sleep disturbances. To shed light on the subject of postpartum depression, explore the following questions:

• What factors may increase the risk of postpartum depression?
• Is postpartum depression predictable?
• How to prevent postpartum depression?
• What are the symptoms of postpartum depression?
• What kinds of postpartum depression treatments exist?

Prompt for Essay about Teenage Depression

Teenage depression is a mental health condition characterized by sadness and diminishing interest in daily activities. It can significantly impact a teenager’s thoughts, emotions, and behavior, often requiring long-term treatment and support.

By discussing the primary symptoms of teenage depression in your paper, you can raise awareness of the issue and encourage those in need to seek assistance. You can pay attention to the following aspects:

• Emotional changes (feelings of sadness, anger, hopelessness, guilt, etc.);
• Behavioral changes (loss of energy and appetite , less attention to personal hygiene, self-harm, etc.);
• New addictions (drugs, alcohol, computer games, etc.).

💡 Research Topics about Depression

• The role of genetics in depression development.
• The effectiveness of different psychotherapeutic interventions for depression.
• Anti-depression non-pharmacological and medication treatment .
• The impact of childhood trauma on the onset of depression later in life.
• Exploring the efficacy of antidepressant medication in different populations.
• The impact of exercise on depression symptoms and treatment outcomes.
• Mild depression: pharmacotherapy and psychotherapy .
• The relationship between sleep disturbances and depression.
• The role of gut microbiota in depression and potential implications for treatment.
• Investigating the impact of social media on depression rates in adolescents.
• Depression, dementia, and delirium in older people .
• The efficacy of cognitive-behavioral therapy in preventing depression relapse.
• The influence of hormonal changes on depression risk.
• Assessing the effectiveness of self-help and digital interventions for depression.
• Herbal and complementary therapies for depression .
• The relationship between personality traits and vulnerability to depression.
• Investigating the long-term consequences of untreated depression on physical health.
• Exploring the link between chronic pain and depression.
• Depression in the elderly male .
• The impact of childhood experiences on depression outcomes in adulthood.
• The use of ketamine and other novel treatments for depression.
• The effect of stigma on depression diagnosis and treatment.
• The conducted family assessment: cases of depression .
• The role of social support in depression recovery.
• The effectiveness of online support groups for individuals with depression.
• Depression and cognitive decline in adults.
• Depression: PICOT question component exploration .
• Exploring the impact of nutrition and dietary patterns on depression symptoms.
• Investigating the efficacy of art-based therapies in depression treatment.
• The role of neuroplasticity in the development and treatment of depression.
• Depression among HIV-positive women .
• The influence of gender on depression prevalence and symptomatology.
• Investigating the impact of workplace factors on depression rates and outcomes.
• The efficacy of family-based interventions in reducing depression symptoms in teenagers.
• Frontline nurses’ burnout, anxiety, depression, and fear statuses .
• The role of early-life stress and adversity in depression vulnerability.
• The impact of various environmental factors on depression rates.
• Exploring the link between depression and cardiovascular health .
• Depression detection in adults in nursing practice .
• Virtual reality as a therapeutic tool for depression treatment.
• Investigating the impact of childhood bullying on depression outcomes.
• The benefits of animal-assisted interventions in depression management.
• Depression and physical exercise .
• The relationship between depression and suicidal behavior .
• The influence of cultural factors on depression symptom expression.
• Investigating the role of epigenetics in depression susceptibility.
• Depression associated with cognitive dysfunction .
• Exploring the impact of adverse trauma on the course of depression.
• The efficacy of acceptance and commitment therapy in treating depression.
• The relationship between depression and substance use disorders .
• Depression and anxiety among college students .
• Investigating the effectiveness of group therapy for depression.
• Depression and chronic medical conditions .

Psychology Research Topics on Depression

• The influence of early attachment experiences on the development of depression.
• The impact of negative cognitive biases on depression symptomatology.
• Depression treatment plan for a queer patient .
• Examining the relationship between perfectionism and depression.
• The role of self-esteem in depression vulnerability and recovery.
• Exploring the link between maladaptive thinking styles (e.g., rumination, catastrophizing) and depression.
• Investigating the impact of social support on depression outcomes and resilience.
• Identifying depression in young adults at an early stage .
• The influence of parenting styles on the risk of depression in children and adolescents.
• The role of self-criticism and self-compassion in depression treatment.
• Exploring the relationship between identity development and depression in emerging adulthood.
• The role of learned helplessness in understanding depression and its treatment.
• Depression in the elderly .
• Examining the connection between self-efficacy beliefs and depression symptoms.
• The influence of social comparison processes on depression and body image dissatisfaction .
• Exploring the impact of trauma-related disorders on depression.
• The role of resilience factors in buffering against the development of depression.
• Investigating the relationship between personality traits and depression.
• Depression and workplace violence .
• The impact of cultural factors on depression prevalence and symptom presentation.
• Investigating the effects of chronic stress on depression risk.
• The role of coping strategies in depression management and recovery.
• The correlation between discrimination/prejudice and depression/anxiety .
• Exploring the influence of gender norms and societal expectations on depression rates.
• The impact of adverse workplace conditions on employee depression.
• Investigating the effectiveness of narrative therapy in treating depression.
• Cognitive behavior and depression in adolescents .
• Childhood emotional neglect and adult depression.
• The influence of perceived social support on treatment outcomes in depression.
• The effects of childhood bullying on the development of depression.
• The impact of intergenerational transmission of depression within families.
• Depression in children: symptoms and treatments .
• Investigating the link between body dissatisfaction and depression in adolescence.
• The influence of adverse life events and chronic stressors on depression risk.
• The effects of peer victimization on the development of depression in adolescence.
• Counselling clients with depression and addiction .
• The role of experiential avoidance in depression and its treatment.
• The impact of social media use and online interactions on depression rates.
• Depression management in adolescent .
• Exploring the relationship between emotional intelligence and depression symptomatology.
• Investigating the influence of cultural values and norms on depression stigma and help-seeking behavior.
• The effects of childhood maltreatment on neurobiological markers of depression.
• Psychological and emotional conditions of suicide and depression .
• Exploring the relationship between body dissatisfaction and depression.
• The influence of self-worth contingencies on depression vulnerability and treatment response.
• The impact of social isolation and loneliness on depression rates.
• Psychology of depression among college students .
• The effects of perfectionistic self-presentation on depression in college students.
• The role of mindfulness skills in depression prevention and relapse prevention.
• Investigating the influence of adverse neighborhood conditions on depression risk.
• Personality psychology and depression .
• The impact of attachment insecurity on depression symptomatology.

Postpartum Depression Research Topics

• Identifying risk factors for postpartum depression.
• Exploring the role of hormonal changes in postpartum depression.
• “Baby blues” or postpartum depression and evidence-based care .
• The impact of social support on postpartum depression.
• The effectiveness of screening tools for early detection of postpartum depression.
• The relationship between postpartum depression and maternal-infant bonding .
• Postpartum depression educational program results .
• Identifying effective interventions for preventing and treating postpartum depression.
• Examining the impact of cultural factors on postpartum depression rates.
• Investigating the role of sleep disturbances in postpartum depression.
• Depression and postpartum depression relationship .
• Exploring the impact of a traumatic birth experience on postpartum depression.
• Assessing the impact of breastfeeding difficulties on postpartum depression.
• Understanding the role of genetic factors in postpartum depression.
• Postpartum depression: consequences .
• Investigating the impact of previous psychiatric history on postpartum depression risk.
• The potential benefits of exercise on postpartum depression symptoms.
• The efficacy of psychotherapeutic interventions for postpartum depression.
• Postpartum depression in the twenty-first century .
• The influence of partner support on postpartum depression outcomes.
• Examining the relationship between postpartum depression and maternal self-esteem.
• The impact of postpartum depression on infant development and well-being.
• Maternal mood symptoms in pregnancy and postpartum depression .
• The effectiveness of group therapy for postpartum depression management.
• Identifying the role of inflammation and immune dysregulation in postpartum depression.
• Investigating the impact of childcare stress on postpartum depression.
• Postpartum depression among low-income US mothers .
• The role of postnatal anxiety symptoms in postpartum depression.
• The impact of postpartum depression on the marital relationship.
• The influence of postpartum depression on parenting practices and parental stress.
• Postpartum depression: symptoms, role of cultural factors, and ways to support .
• Investigating the efficacy of pharmacological treatments for postpartum depression.
• The impact of postpartum depression on breastfeeding initiation and continuation.
• The relationship between postpartum depression and post-traumatic stress disorder .
• Postpartum depression and its identification .
• The impact of postpartum depression on cognitive functioning and decision-making.
• Investigating the influence of cultural norms and expectations on postpartum depression rates.
• The impact of maternal guilt and shame on postpartum depression symptoms.
• Beck’s postpartum depression theory: purpose, concepts, and significance .
• Understanding the role of attachment styles in postpartum depression vulnerability.
• Investigating the effectiveness of online support groups for women with postpartum depression.
• The impact of socioeconomic factors on postpartum depression prevalence.
• Perinatal depression: research study and design .
• The efficacy of mindfulness-based interventions for postpartum depression.
• Investigating the influence of birth spacing on postpartum depression risk.
• The role of trauma history in postpartum depression development.
• The link between the birth experience and postnatal depression .
• How does postpartum depression affect the mother-infant interaction and bonding ?
• The effectiveness of home visiting programs in preventing and managing postpartum depression.
• Assessing the influence of work-related stress on postpartum depression.
• The relationship between postpartum depression and pregnancy-related complications.
• The role of personality traits in postpartum depression vulnerability.

🔎 Depression Essay Titles

Depression essay topics: cause & effect.

• The effects of childhood trauma on the development of depression in adults.
• The impact of social media usage on the prevalence of depression in adolescents.
• “Predictors of Postpartum Depression” by Katon et al.
• The effects of environmental factors on depression rates.
• The relationship between academic pressure and depression among college students.
• The relationship between financial stress and depression.
• The best solution to predict depression because of bullying .
• How does long-term unemployment affect mental health ?
• The effects of unemployment on mental health, particularly the risk of depression.
• The impact of genetics and family history of depression on an individual’s likelihood of developing depression.
• The relationship between depression and substance abuse .
• Child abuse and depression .
• The role of gender in the manifestation and treatment of depression.
• The effects of chronic stress on the development of depression.
• The link between substance abuse and depression.
• Depression among students at Elon University .
• The influence of early attachment styles on an individual’s vulnerability to depression.
• The effects of sleep disturbances on the severity of depression.
• Chronic illness and the risk of developing depression.
• Depression: symptoms and treatment .
• Adverse childhood experiences and the likelihood of experiencing depression in adulthood.
• The relationship between chronic illness and depression.
• The role of negative thinking patterns in the development of depression.
• Effects of depression among adolescents .
• The effects of poor body image and low self-esteem on the prevalence of depression.
• The influence of social support systems on preventing symptoms of depression.
• The effects of child neglect on adult depression rates.
• Depression caused by hormonal imbalance .
• The link between perfectionism and the risk of developing depression.
• The effects of a lack of sleep on depression symptoms.
• The effects of childhood abuse and neglect on the risk of depression.
• Social aspects of depression and anxiety .
• The impact of bullying on the likelihood of experiencing depression.
• The role of serotonin and neurotransmitter imbalances in the development of depression.
• The impact of a poor diet on depression rates.
• Depression and anxiety run in the family .
• The effects of childhood poverty and socioeconomic status on depression rates in adults.
• The impact of divorce on depression rates.
• The relationship between traumatic life events and the risk of developing depression.
• The influence of personality traits on susceptibility to depression.
• The impact of workplace stress on depression rates.
• Depression in older adults: causes and treatment .
• The impact of parental depression on children’s mental health outcomes.
• The effects of social isolation on the prevalence and severity of depression.
• The role of cultural factors in the manifestation and treatment of depression.
• The relationship between childhood bullying victimization and future depressive symptoms.
• The impact of early intervention and prevention programs on reducing the risk of postpartum depression.
• Treating mood disorders and depression .
• How do hormonal changes during pregnancy contribute to the development of depression?
• The effects of sleep deprivation on the onset and severity of postpartum depression.
• The impact of social media on depression rates among teenagers.
• The role of genetics in the development of depression.
• The impact of bullying on adolescent depression rates.
• Mental illness, depression, and wellness issues .
• The effects of a sedentary lifestyle on depression symptoms.
• The correlation between academic pressure and depression in students.
• The relationship between perfectionism and depression.
• The correlation between trauma and depression in military veterans.
• Anxiety and depression during childhood and adolescence .
• The impact of racial discrimination on depression rates among minorities.
• The relationship between chronic pain and depression.
• The impact of social comparison on depression rates among young adults.
• The effects of childhood abuse on adult depression rates.

Depression Argumentative Essay Topics

• The role of social media in contributing to depression among teenagers.
• The effectiveness of antidepressant medication: an ongoing debate.
• Depression treatment: therapy or medications ?
• Should depression screening be mandatory in schools and colleges?
• Is there a genetic predisposition to depression?
• The stigma surrounding depression: addressing misconceptions and promoting understanding.
• Implementation of depression screening in primary care .
• Is psychotherapy more effective than medication in treating depression?
• Is teenage depression overdiagnosed or underdiagnosed: a critical analysis.
• The connection between depression and substance abuse: untangling the relationship.
• Humanistic therapy of depression .
• Should ECT (electroconvulsive therapy) be a treatment option for severe depression?
• Where is depression more prevalent: in urban or rural communities? Analyzing the disparities.
• Is depression a result of chemical imbalance in the brain? Debunking the myth.
• Depression: a serious mental and behavioral problem .
• Should depression medication be prescribed for children and adolescents?
• The effectiveness of mindfulness-based interventions in managing depression.
• Should depression in the elderly be considered a normal part of aging?
• Is depression hereditary? Investigating the role of genetics in depression risk.
• Different types of training in managing the symptoms of depression .
• The effectiveness of online therapy platforms in treating depression.
• Should psychedelic therapy be explored as an alternative treatment for depression?
• The connection between depression and cardiovascular health: Is there a link?
• The effectiveness of cognitive-behavioral therapy in preventing depression relapse.
• Depression as a bad a clinical condition .
• Should mind-body interventions (e.g., yoga , meditation) be integrated into depression treatment?
• Should emotional support animals be prescribed for individuals with depression?
• The effectiveness of peer support groups in decreasing depression symptoms.
• The use of antidepressants: are they overprescribed or necessary for treating depression?
• Adult depression and anxiety as a complex problem .
• The effectiveness of therapy versus medication in treating depression.
• The stigma surrounding depression and mental illness: how can we reduce it?
• The debate over the legalization of psychedelic drugs for treating depression.
• The relationship between creativity and depression: does one cause the other?
• Cognitive-behavioral therapy for generalized anxiety disorder and depression .
• The role of childhood trauma in shaping adult depression: Is it always a causal factor?
• The debate over the medicalization of sadness and grief as forms of depression.
• Alternative therapies, such as acupuncture or meditation, are effective in treating depression.
• Depression as a widespread mental condition .

Controversial Topics about Depression

• The existence of “chemical imbalance” in depression: fact or fiction?
• The over-reliance on medication in treating depression: are alternatives neglected?
• Is depression overdiagnosed and overmedicated in Western society?
• Measurement of an individual’s level of depression .
• The role of Big Pharma in shaping the narrative and treatment of depression.
• Should antidepressant advertisements be banned?
• The inadequacy of current diagnostic criteria for depression: rethinking the DSM-5.
• Is depression a biological illness or a product of societal factors?
• Literature review on depression .
• The overemphasis on biological factors in depression treatment: ignoring environmental factors.
• Is depression a normal reaction to an abnormal society?
• The influence of cultural norms on the perception and treatment of depression.
• Should children and adolescents be routinely prescribed antidepressants?
• The role of family in depression treatment .
• The connection between depression and creative genius: does depression enhance artistic abilities?
• The ethics of using placebo treatment for depression studies.
• The impact of social and economic inequalities on depression rates.
• Is depression primarily a mental health issue or a social justice issue?
• Depression disassembling and treating .
• Should depression screening be mandatory in the workplace?
• The influence of gender bias in the diagnosis and treatment of depression.
• The controversial role of religion and spirituality in managing depression.
• Is depression a result of individual weakness or societal factors?
• Abnormal psychology: anxiety and depression case .
• The link between depression and obesity: examining the bidirectional relationship.
• The connection between depression and academic performance : causation or correlation?
• Should depression medication be available over the counter?
• The impact of internet and social media use on depression rates: harmful or beneficial?
• Interacting in the workplace: depression .
• Is depression a modern epidemic or simply better diagnosed and identified?
• The ethical considerations of using animals in depression research.
• The effectiveness of psychedelic therapies for treatment-resistant depression.
• Is depression a disability? The debate on workplace accommodations.
• Polysubstance abuse among adolescent males with depression .
• The link between depression and intimate partner violence : exploring the relationship.
• The controversy surrounding “happy” pills and the pursuit of happiness.
• Is depression a choice? Examining the role of personal responsibility.

Good Titles for Depression Essays

• The poetic depictions of depression: exploring its representation in literature.
• The melancholic symphony: the influence of depression on classical music.
• Moderate depression symptoms and treatment .
• Depression in modern music: analyzing its themes and expressions.
• Cultural perspectives on depression: a comparative analysis of attitudes in different countries.
• Contrasting cultural views on depression in Eastern and Western societies.
• Diagnosing depression in the older population .
• The influence of social media on attitudes and perceptions of depression in global contexts.
• Countries with progressive approaches to mental health awareness.
• From taboo to acceptance: the evolution of attitudes towards depression.
• Depression screening tool in acute settings .
• The Bell Jar : analyzing Sylvia Plath’s iconic tale of depression .
• The art of despair: examining Frida Kahlo’s self-portraits as a window into depression.
• The Catcher in the Rye : Holden Caulfield’s battle with adolescent depression.
• Music as therapy: how jazz artists turned depression into art.
• Depression screening tool for a primary care center .
• The Nordic paradox: high depression rates in Scandinavian countries despite high-quality healthcare.
• The Stoic East: how Eastern philosophies approach and manage depression.
• From solitude to solidarity: collective approaches to depression in collectivist cultures.
• The portrayal of depression in popular culture: a critical analysis of movies and TV shows.
• The depression screening training in primary care .
• The impact of social media influencers on depression rates among young adults.
• The role of music in coping with depression: can specific genres or songs help alleviate depressive symptoms?
• The representation of depression in literature: a comparative analysis of classic and contemporary works.
• The use of art as a form of self-expression and therapy for individuals with depression.
• Depression management guidelines implementation .
• The role of religion in coping with depression: Christian and Buddhist practices.
• The representation of depression in the video game Hellblade: Senua’s Sacrifice .
• The role of nature in coping with depression: can spending time outdoors help alleviate depressive symptoms?
• The effectiveness of dance/movement therapy in treating depression among older adults.
• The National Institute for Health: depression management .
• The portrayal of depression in stand-up comedy: a study of comedians like Maria Bamford and Chris Gethard.
• The role of spirituality in coping with depression: Islamic and Hindu practices .
• The portrayal of depression in animated movies : an analysis of Inside Out and The Lion King .
• The representation of depression by fashion designers like Alexander McQueen and Rick Owens.
• Depression screening in primary care .
• The portrayal of depression in documentaries: an analysis of films like The Bridge and Happy Valley .
• The effectiveness of wilderness therapy in treating depression among adolescents.
• The connection between creativity and depression: how art can help heal.
• The role of Buddhist and Taoist practices in coping with depression.
• Mild depression treatment research funding sources .
• The portrayal of depression in podcasts: an analysis of the show The Hilarious World of Depression .
• The effectiveness of drama therapy in treating depression among children and adolescents.
• The representation of depression in the works of Vincent van Gogh and Edvard Munch.
• Depression in young people: articles review .
• The impact of social media on political polarization and its relationship with depression.
• The role of humor in coping with depression: a study of comedians like Ellen DeGeneres.
• The portrayal of depression in webcomics: an analysis of the comics Hyperbole and a Half .
• The effect of social media on mental health stigma and its relationship with depression.
• Depression and the impact of human services workers .
• The masked faces: hiding depression in highly individualistic societies.

💭 Depression Speech Topics

Informative speech topics about depression.

• Different types of depression and their symptoms.
• The causes of depression: biological, psychological, and environmental factors.
• How depression and physical issues are connected .
• The prevalence of depression in different age groups and demographics.
• The link between depression and anxiety disorders .
• Physical health: The effects of untreated depression.
• The role of genetics in predisposing individuals to depression.
• What you need to know about depression .
• How necessary is early intervention in treating depression?
• The effectiveness of medication in treating depression.
• The role of exercise in managing depressive symptoms.
• Depression in later life: overview .
• The relationship between substance abuse and depression.
• The impact of trauma on depression rates and treatment.
• The effectiveness of mindfulness meditation in managing depressive symptoms.
• Enzymes conversion and metabolites in major depression .
• The benefits and drawbacks of electroconvulsive therapy for severe depression.
• The effect of gender and cultural norms on depression rates and treatment.
• The effectiveness of alternative therapies for depression, such as acupuncture and herbal remedies .
• The importance of self-care in managing depression.
• Symptoms of anxiety, depression, and peritraumatic dissociation .
• The role of support systems in managing depression.
• The effectiveness of cognitive-behavioral therapy in treating depression.
• The benefits and drawbacks of online therapy for depression.
• The role of spirituality in managing depression.
• Depression among minority groups .
• The benefits and drawbacks of residential treatment for severe depression.
• What is the relationship between childhood trauma and adult depression?
• How effective is transcranial magnetic stimulation (TMS) for treatment-resistant depression?
• The benefits and drawbacks of art therapy for depression.
• Mood disorder: depression and bipolar .
• The impact of social media on depression rates.
• The effectiveness of dialectical behavior therapy (DBT) in treating depression.
• Depression in older people .
• The impact of seasonal changes on depression rates and treatment options.
• The impact of depression on daily life and relationships, and strategies for coping with the condition.
• The stigma around depression and the importance of seeking help.

Persuasive Speech Topics about Depression

• How important is it to recognize the signs and symptoms of depression ?
• How do you support a loved one who is struggling with depression?
• The importance of mental health education in schools to prevent and manage depression.
• Social media: the rise of depression and anxiety .
• Is there a need to increase funding for mental health research to develop better treatments for depression?
• Addressing depression in minority communities: overcoming barriers and disparities.
• The benefits of including alternative therapies , such as yoga and meditation, in depression treatment plans.
• Challenging media portrayals of depression: promoting accurate representations.
• Two sides of depression disease .
• How social media affects mental health: the need for responsible use to prevent depression.
• The importance of early intervention: addressing depression in schools and colleges.
• The benefits of seeking professional help for depression.
• There is a need for better access to mental health care, including therapy and medication, for those suffering from depression.
• Depression in adolescents and suitable interventions .
• How do you manage depression while in college or university?
• The role of family and friends in supporting loved ones with depression and encouraging them to seek help.
• The benefits of mindfulness and meditation for depression.
• The link between sleep and depression, and how to improve sleep habits.
• How do you manage depression while working a high-stress job?
• Approaches to treating depression .
• How do you manage depression during pregnancy and postpartum?
• The importance of prioritizing employee mental health and providing resources for managing depression in the workplace.
• How should you manage depression while caring for a loved one with a chronic illness?
• How to manage depression while dealing with infertility or pregnancy loss.
• Andrew Solomon: why we can’t talk about depression .
• Destigmatizing depression: promoting mental health awareness and understanding.
• Raising funds for depression research: investing in mental health advances.
• The power of peer support: establishing peer-led programs for depression.
• Accessible mental health services: ensuring treatment for all affected by depression.
• Evidence-based screening for depression in acute care .
• The benefits of journaling for mental health: putting your thoughts on paper to heal.
• The power of positivity: changing your mindset to fight depression .
• The healing power of gratitude in fighting depression.
• The connection between diet and depression: eating well can improve your mood.
• Teen depression and suicide in Soto’s The Afterlife .
• The benefits of therapy for depression: finding professional help to heal.
• The importance of setting realistic expectations when living with depression.

📝 How to Write about Depression: Essay Structure

We’ve prepared some tips and examples to help you structure your essay and communicate your ideas.

Essay about Depression: Introduction

An introduction is the first paragraph of an essay. It plays a crucial role in engaging the reader, offering the context, and presenting the central theme.

A good introduction typically consists of 3 components:

• Hook. The hook captures readers’ attention and encourages them to continue reading.
• Background information. Background information provides context for the essay.
• Thesis statement. A thesis statement expresses the essay’s primary idea or central argument.

Hook : Depression is a widespread mental illness affecting millions worldwide.

Background information : Depression affects your emotions, thoughts, and behavior. If you suffer from depression, engaging in everyday tasks might become arduous, and life may appear devoid of purpose or joy.

Depression Essay Thesis Statement

A good thesis statement serves as an essay’s road map. It expresses the author’s point of view on the issue in 1 or 2 sentences and presents the main argument.

Thesis statement : The stigma surrounding depression and other mental health conditions can discourage people from seeking help, only worsening their symptoms.

Essays on Depression: Body Paragraphs

The main body of the essay is where you present your arguments. An essay paragraph includes the following:

• a topic sentence,
• evidence to back up your claim,
• explanation of why the point is essential to the argument;
• a link to the next paragraph.

Topic sentence : Depression is a complex disorder that requires a personalized treatment approach, comprising both medication and therapy.

Evidence : Medication can be prescribed by a healthcare provider or a psychiatrist to relieve the symptoms. Additionally, practical strategies for managing depression encompass building a support system, setting achievable goals, and practicing self-care.

Depression Essay: Conclusion

The conclusion is the last part of your essay. It helps you leave a favorable impression on the reader.

The perfect conclusion includes 3 elements:

• Rephrased thesis statement.
• Summary of the main points.
• Final opinion on the topic.

Rephrased thesis: In conclusion, overcoming depression is challenging because it involves a complex interplay of biological, psychological, and environmental factors that affect an individual’s mental well-being.

Summary: Untreated depression heightens the risk of engaging in harmful behaviors such as substance abuse and can also result in negative thought patterns, diminished self-esteem, and distorted perceptions of reality.

We hope you’ve found our article helpful and learned some new information. If so, feel free to share it with your friends. You can also try our free online topic generator !

• Pain, anxiety, and depression – Harvard Health | Harvard Health Publishing
• Depression-related increases and decreases in appetite reveal dissociable patterns of aberrant activity in reward and interoceptive neurocircuitry – PMC | National Library of Medicine
• How to Get Treatment for Postpartum Depression – The New York Times
• What Is Background Information and What Purpose Does It Serve? | Indeed.com
• Thesis | Harvard College Writing Center
• Topic Sentences: How Do You Write a Great One? | Grammarly Blog

725 Research Proposal Topics & Title Ideas in Education, Psychology, Business, & More

414 proposal essay topics for projects, research, & proposal arguments.

I Serve With Sen. John Fetterman. I Struggled With Depression, Too

In a candid, personal essay, Sen. Tina Smith of Minnesota writes about John Fetterman, her own struggle with depression, seeking help, and finding a way back to health.

Sen. Tina Smith

I’ve only worked with Sen. John Fetterman for a short time, but in the last two months, I’ve been struck by his resilience and heart. Everyone’s experience is different, but John is doing exactly what everyone should when they’re facing depression: seek help and take the time to get better.

Seeking help when you need it is a sign of strength, not weakness. In admitting himself to a Maryland hospital for “clinical depression,” as John’s chief of staff put it, John is demonstrating that for all of us.

For people who have experienced depression , seeing someone else suffering can take you back to your own experience. If you are seeing the news about John, it may bring up old feelings for you. It did for me.

I can’t speak to John’s personal experience, and I’m not comparing my own struggles with depression to what he’s going through, because everyone is different. But I’ve learned that there’s a lot of good that comes from people like John and me speaking openly about our mental health challenges.

I first experienced depression in my late teens, and then again in my thirties when I was a young mom. For me, depression drained hope away, and the promise that I’d ever feel hopeful again. I couldn’t feel joy or love or contentment, and I couldn’t see a way I’d ever feel that way again.

The worst part about depression is how treacherously it saps your capacity to function—treacherous because depression can feel like a personal weakness rather than what it is: a malfunction of the brain.

So, I want to say that, if you or someone you know is feeling this way, there’s help, and you can feel better. You can reach the National Suicide and Crisis Lifeline by dialing or texting 988.

It takes courage to ask for help, but you can do it.

In my thirties, when my psychologist suggested that I take a diagnostic test, and then informed me that I clearly was suffering from depression, I rejected her diagnosis. What’s wrong with me is me, I thought. I told myself that I could fix this. But then I realized she was right. I listened. And thank God for her. Thanks to her empathy and her medical and professional expertise, I slowly swam back to the life and people I loved, and I got better.

I was blessed to get early help, and to have access to the medicines and treatment that allowed me to recover. Everyone should have the same access to mental health care, regardless of our insurance, our ZIP code, or our age. Yet that is far from true for many Americans and that’s so wrong.

I’m proud of Minnesota’s legacy of helping and healing people experiencing mental illness, and I’m determined to carry on this work. Minnesota Sen. Paul Wellstone worked across the aisle with his wife Sheila by his side to champion mental health parity—the principle that insurance companies should cover mental health just like they cover other medical care. After Paul’s death, Sen. Al Franken worked with Paul’s son David to write the final rules for the law Paul pushed.

Their work put us on the path toward mental health parity, but there’s more work to do to truly make the spirit of that law a reality and to ensure everyone has complete coverage for mental health services.

So, I ask you to join me. Speak out. If you or someone you love is struggling with mental health challenges, don’t let anything get in the way of getting help, any more than you would resist getting help if you had the flu or a broken arm.

My experience taught me how important getting help can be. And I also remember the experience of slowly emerging from depression: a little more energy every day. A little more capacity to pay attention to the people and things I love. The colors of the world came back.

I’m thinking of John and his family and wishing him the best. He has a terrific team around him in D.C. and back home in Pennsylvania. And while I can’t wait to see him back in the Senate, working on issues he cares so deeply about, I know he is doing the right thing—taking care of himself.

Tina Smith is a Democratic senator from Minnesota. As a member of the Senate Health and Education Committee, Smith is a leader in the fight to make mental health care more affordable and accessible. She has spoken on the Senate floor and regularly shares her story about her personal experience with depression in an effort to destigmatize talking about mental health.

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• BOOK REVIEW
• 29 March 2024

The great rewiring: is social media really behind an epidemic of teenage mental illness?

• Candice L. Odgers 0

Candice L. Odgers is the associate dean for research and a professor of psychological science and informatics at the University of California, Irvine. She also co-leads international networks on child development for both the Canadian Institute for Advanced Research in Toronto and the Jacobs Foundation based in Zurich, Switzerland.

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Social-media platforms aren’t always social. Credit: Getty

The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness Jonathan Haidt Allen Lane (2024)

Two things need to be said after reading The Anxious Generation . First, this book is going to sell a lot of copies, because Jonathan Haidt is telling a scary story about children’s development that many parents are primed to believe. Second, the book’s repeated suggestion that digital technologies are rewiring our children’s brains and causing an epidemic of mental illness is not supported by science. Worse, the bold proposal that social media is to blame might distract us from effectively responding to the real causes of the current mental-health crisis in young people.

Haidt asserts that the great rewiring of children’s brains has taken place by “designing a firehose of addictive content that entered through kids’ eyes and ears”. And that “by displacing physical play and in-person socializing, these companies have rewired childhood and changed human development on an almost unimaginable scale”. Such serious claims require serious evidence.

Collection: Promoting youth mental health

Haidt supplies graphs throughout the book showing that digital-technology use and adolescent mental-health problems are rising together. On the first day of the graduate statistics class I teach, I draw similar lines on a board that seem to connect two disparate phenomena, and ask the students what they think is happening. Within minutes, the students usually begin telling elaborate stories about how the two phenomena are related, even describing how one could cause the other. The plots presented throughout this book will be useful in teaching my students the fundamentals of causal inference, and how to avoid making up stories by simply looking at trend lines.

Hundreds of researchers, myself included, have searched for the kind of large effects suggested by Haidt. Our efforts have produced a mix of no, small and mixed associations. Most data are correlative. When associations over time are found, they suggest not that social-media use predicts or causes depression, but that young people who already have mental-health problems use such platforms more often or in different ways from their healthy peers 1 .

These are not just our data or my opinion. Several meta-analyses and systematic reviews converge on the same message 2 – 5 . An analysis done in 72 countries shows no consistent or measurable associations between well-being and the roll-out of social media globally 6 . Moreover, findings from the Adolescent Brain Cognitive Development study, the largest long-term study of adolescent brain development in the United States, has found no evidence of drastic changes associated with digital-technology use 7 . Haidt, a social psychologist at New York University, is a gifted storyteller, but his tale is currently one searching for evidence.

Of course, our current understanding is incomplete, and more research is always needed. As a psychologist who has studied children’s and adolescents’ mental health for the past 20 years and tracked their well-being and digital-technology use, I appreciate the frustration and desire for simple answers. As a parent of adolescents, I would also like to identify a simple source for the sadness and pain that this generation is reporting.

A complex problem

There are, unfortunately, no simple answers. The onset and development of mental disorders, such as anxiety and depression, are driven by a complex set of genetic and environmental factors. Suicide rates among people in most age groups have been increasing steadily for the past 20 years in the United States. Researchers cite access to guns, exposure to violence, structural discrimination and racism, sexism and sexual abuse, the opioid epidemic, economic hardship and social isolation as leading contributors 8 .

How social media affects teen mental health: a missing link

The current generation of adolescents was raised in the aftermath of the great recession of 2008. Haidt suggests that the resulting deprivation cannot be a factor, because unemployment has gone down. But analyses of the differential impacts of economic shocks have shown that families in the bottom 20% of the income distribution continue to experience harm 9 . In the United States, close to one in six children live below the poverty line while also growing up at the time of an opioid crisis, school shootings and increasing unrest because of racial and sexual discrimination and violence.

The good news is that more young people are talking openly about their symptoms and mental-health struggles than ever before. The bad news is that insufficient services are available to address their needs. In the United States, there is, on average, one school psychologist for every 1,119 students 10 .

Haidt’s work on emotion, culture and morality has been influential; and, in fairness, he admits that he is no specialist in clinical psychology, child development or media studies. In previous books, he has used the analogy of an elephant and its rider to argue how our gut reactions (the elephant) can drag along our rational minds (the rider). Subsequent research has shown how easy it is to pick out evidence to support our initial gut reactions to an issue. That we should question assumptions that we think are true carefully is a lesson from Haidt’s own work. Everyone used to ‘know’ that the world was flat. The falsification of previous assumptions by testing them against data can prevent us from being the rider dragged along by the elephant.

A generation in crisis

Two things can be independently true about social media. First, that there is no evidence that using these platforms is rewiring children’s brains or driving an epidemic of mental illness. Second, that considerable reforms to these platforms are required, given how much time young people spend on them. Many of Haidt’s solutions for parents, adolescents, educators and big technology firms are reasonable, including stricter content-moderation policies and requiring companies to take user age into account when designing platforms and algorithms. Others, such as age-based restrictions and bans on mobile devices, are unlikely to be effective in practice — or worse, could backfire given what we know about adolescent behaviour.

A third truth is that we have a generation in crisis and in desperate need of the best of what science and evidence-based solutions can offer. Unfortunately, our time is being spent telling stories that are unsupported by research and that do little to support young people who need, and deserve, more.

Nature 628 , 29-30 (2024)

doi: https://doi.org/10.1038/d41586-024-00902-2

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Mount Everest was the riskiest place I had practiced medicine until I became an OB/GYN in the South

In post-dobbs georgia, unlike on everest, i didn't choose the restrictions and threats i now practice under, by mimi zieman.

On the eastern glacier of Everest in Tibet, where avalanches boomed in the distance and icy winds blew through my nylon tent, I tucked in at night within a cocoon of uncertainty. I kept my stethoscope and blood pressure cuff nestled by my thighs to keep them warm and ready to use. Months stretched out in isolation with me on high alert — alone in my medical role — fearing I’d fail when most needed. Most nights I shivered as I donned my down layers, slept with two hats, and tucked a hot water bottle beside my feet for warmth. I envied the rest of the all-male team who slept bare.

In the middle of one night, my fears became reality. Two severely injured climbers crawled over uneven rocks to stumble into camp. They shouted our names for help, piercing the black air. Half asleep, with shoelaces untied and blades of hail stinging my face, I stumbled toward the sound of their voices, then helped them back to our tents, and began a marathon of care. At 18,000 feet, the thin air mirrored my nascent experience as a 25-year-old medical student. I worried about their conditions and the care I was delivering. Was I doing everything correctly? Remembering the protocols? What else should I be doing?  

My journey to Everest was a leap of faith. I was raised a New York City girl and felt like an unlikely candidate for a Himalayan expedition, but I couldn’t resist the call of the mountains. Once I joined the team as the Medical Officer, I dove into mountaineering medicine, sought counsel from experts, and armed myself with knowledge. Yet nothing could prepare me for how isolated we’d be. We saw no outsiders for months and knew there was no chance for rescue on the East Face of the mountain in Tibet. 

A few days later, back in Base Camp, I laid out packages of gauze, tape, scissors, antiseptic and checked the antibiotics on hand. While tending to a climber with severe frostbite injuries affecting both hands and feet, I tipped his hat over his eyes and suggested he look away. I removed the bandage I’d placed at Advanced Base Camp from his first finger. A shrunken black stub of a distal phalanx — the whole tip of his finger — stared back. He lifted his hat, saw his finger, and looked up at me with wide eyes. Then he rounded his back away from me like an animal curled up in defense. More unwrapping, more fingers, more rocking with sobs, digit after digit, dead, inch-long black fingertips. He wailed, shook his head, and his sobs pierced my heart. I wished I could protect him from this pain. His eyes were pleading, but I had no answers. I, too, was surprised at how rapidly his shredded fingers had turned to coal.

Since the Dobbs decision, I don’t have the autonomy I had on the mountain to deliver the best care possible.

“Will I ever be able to climb again?” he asked. The gauze adhered to his final two fingers. 

I didn’t have an answer.

My only motivation was to provide the best care possible while being present with compassion. We were all at the knife edge of our limits and digging deeply for strength.

Each of us on that mountain had weighed our risks and vulnerabilities and had chosen to be there. The climbers had chosen the extreme challenge of Everest and did everything in their power to remain alive. I had chosen to work in these circumstances and was delivering the best care I could under difficult conditions.

Not so in my OB/GYN practice in Georgia. Since the Dobbs decision, I don’t have the autonomy I had on the mountain to deliver the best care possible. This is a different kind of isolation, and it’s more unnerving. Despite years of medical training and a commitment to evidence-based care, physicians are hamstrung by state laws, and our patients are suffering. 

A few weeks ago, I entered an exam room to find a young woman staring at her phone, wearing a college sweatshirt and crocs decked out with charms. She had driven alone to Georgia from Tennessee seeking an abortion. Georgia law permits abortions  until approximately two weeks after a missed period, whereas Tennessee bans all procedures with narrow medical emergency exceptions .

After discussing how she felt and clarifying information in her medical history, I said, “Your ultrasound doesn’t show a pregnancy in the uterus, which can happen for a few reasons, most commonly because it’s too early in pregnancy. But the level of pregnancy hormone in your blood and medical history makes me concerned you could have an ectopic pregnancy — one that grows outside the uterus, typically in the fallopian tubes.”

Here, the peaks are legal hurdles, the valleys emotional.

We discussed what might be going on and the next steps we could take, but this young woman dissolved into tears. Getting advanced care to rule out an ectopic pregnancy would require involving her health insurance, which would alert her parents, something she wanted to avoid. I left the room to give her space and time to compose herself while I went to investigate options for care. 

Sobbing patients overwhelmed by difficult decisions resulting from abortion restrictions are now part of our everyday practice as OB/GYNs. We’re not discussing plans of care based on science — we’re sorting out travel, logistics, time off work, childcare, emotional distress, and legal ramifications. Here, the peaks are legal hurdles, the valleys emotional.

This is taking a toll on us. A recent survey by EL Sabbath et al. of OB/GYNs in states with bans documents immense personal impacts “including distress at having to delay essential patient care, fears of legal ramifications, mental health effects, and planned or actual attrition.” The majority reported symptoms of anxiety or depression as a direct consequence of Dobbs. Ninety-three percent of respondents had situations where they or their colleagues could not follow standard of care. Eleven percent had already moved to another state without restrictions, and 60% considered leaving but have family and other obligations making them stay for now.

Although we’ve spent years in medical training, our expertise has been erased by politicians with no medical background. Not being able to practice in accordance with the ethical principles of respecting patient privacy and autonomy in the decision-making process is wounding us.

A May 2023 survey found that 55% of Idaho OB-GYNs were seriously or somewhat considering leaving the state due to the abortion ban, and a hospital there was forced to close its labor and delivery unit due to related staffing issues. Fewer OB/GYNS means less maternal care and yet many of the states with abortion restrictions have the highest maternal mortality rates.

Take this a step back and medical trainees are being affected. Abortion bans are affecting almost half of OB/GYN training programs. A recent survey of medical students in Indiana found 70% were less likely to pursue residency in a state with abortion bans. With decreased training — and diminishing numbers of OB/GYNs willing to practice in these states —  maternal mortality will rise. Care of other gynecological conditions such as endometriosis, infertility, fibroids and cancer will suffer. This affects the most vulnerable among us, low-income and minority patients.

My patient’s insurance would only work in Tennessee. She reminded me of my youngest daughter. I couldn’t picture her processing this information on her own. I was most worried that my patient would need to drive herself back across state lines in this fraught emotional state.

Unlike my experience on Everest, I am not choosing these risks — to my patients or to myself — of practicing under untenable circumstances where I cannot deliver optimal care.

She returned to Tennessee, where her bloodwork confirmed an ectopic pregnancy. Even though treatment of ectopic pregnancies is permitted in that state, the hospital released her without immediate treatment. Delayed care could put her at risk for impaired future fertility, emergency rather than elective surgery, and even death. I can only hope none of that happened. Treating people crossing state lines, who we cannot adequately care for ourselves, is stressful. I still think of her.

I’ve also been thinking a lot about the decision I made to go to Everest with the risks involved and the potential for trauma. I’d joined the team to experience the majesty of the Himalayas. To wake up to fine blue mountain light, live within vastness, and quell the warnings from girlhood to stay small and be safe. To this end, I made peace with the risks I was taking and ultimately grew from facing my fears. When trauma beset us, each team member grew into the best version of themselves.

My family moved to Georgia almost three decades ago, a different kind of unlikely for this city-raised girl. I grew to love the rolling hills of north Georgia, the breathtaking palette of autumn, the scent of apple cider and boiled peanuts. I learned how to cook collards — without ham — their rough stems of veins running through me.

But in the South now, we are not expanding and growing; we are shrinking, boxed in by medical practice governed by legislators, lawyers and hospital administrators. 

Unlike my experience on Everest, I am not choosing these risks — to my patients or to myself — of practicing under untenable circumstances where I cannot deliver optimal care. If I were finishing my training today and choosing somewhere to practice, I would not come to this state or anywhere with these restrictions on practice. 

I would never have predicted, when I was shivering, afraid, and alone providing care on the mountain, that I would feel threatened 36 years later by simply practicing basic healthcare in America. I couldn’t have known that after studying and working hard, I would not be able to put my education, knowledge, and skills to their best use. That I would be hampered when fulfilling the essence of my dream to care for women with skill and compassion. I couldn’t have known how alone, isolated and abandoned I would feel. Right here, at home. 

about this topic

• As more abortion bans occur, many patients must travel hundreds of miles for care — or be stranded
• Yes, some medication abortion patients go to the ER — but it may not be for what you think
• Supreme Court restricting mifepristone would be a "slippery slope" for future drugs

Mimi Zieman MD is the author of " Tap Dancing on Everest " (Falcon, April 2024), and "The Post-Roe Monologues," a play that has been performed in multiple cities. A physician, she has also co-authored sixteen editions of "Managing Contraception." Her writing has appeared in Newsweek, The Sun Magazine, Ms. Magazine, The Forward, NBC News THINK, Dorothy Parker’s Ashes, and other publications.

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3. problems students are facing at public k-12 schools.

We asked teachers about how students are doing at their school. Overall, many teachers hold negative views about students’ academic performance and behavior.

• 48% say the academic performance of most students at their school is fair or poor; a third say it’s good and only 17% say it’s excellent or very good.
• 49% say students’ behavior at their school is fair or poor; 35% say it’s good and 13% rate it as excellent or very good.

Teachers in elementary, middle and high schools give similar answers when asked about students’ academic performance. But when it comes to students’ behavior, elementary and middle school teachers are more likely than high school teachers to say it’s fair or poor (51% and 54%, respectively, vs. 43%).

Teachers from high-poverty schools are more likely than those in medium- and low-poverty schools to say the academic performance and behavior of most students at their school are fair or poor.

The differences between high- and low-poverty schools are particularly striking. Most teachers from high-poverty schools say the academic performance (73%) and behavior (64%) of most students at their school are fair or poor. Much smaller shares of teachers from low-poverty schools say the same (27% for academic performance and 37% for behavior).

In turn, teachers from low-poverty schools are far more likely than those from high-poverty schools to say the academic performance and behavior of most students at their school are excellent or very good.

Lasting impact of the COVID-19 pandemic

Among those who have been teaching for at least a year, about eight-in-ten teachers say the lasting impact of the pandemic on students’ behavior, academic performance and emotional well-being has been very or somewhat negative. This includes about a third or more saying that the lasting impact has been very negative in each area.

Shares ranging from 11% to 15% of teachers say the pandemic has had no lasting impact on these aspects of students’ lives, or that the impact has been neither positive nor negative. Only about 5% say that the pandemic has had a positive lasting impact on these things.

A smaller majority of teachers (55%) say the pandemic has had a negative impact on the way parents interact with teachers, with 18% saying its lasting impact has been very negative.

These results are mostly consistent across teachers of different grade levels and school poverty levels.

Major problems at school

When we asked teachers about a range of problems that may affect students who attend their school, the following issues top the list:

• Poverty (53% say this is a major problem at their school)
• Chronic absenteeism – that is, students missing a substantial number of school days (49%)
• Anxiety and depression (48%)

One-in-five say bullying is a major problem among students at their school. Smaller shares of teachers point to drug use (14%), school fights (12%), alcohol use (4%) and gangs (3%).

Differences by school level

Similar shares of teachers across grade levels say poverty is a major problem at their school, but other problems are more common in middle or high schools:

• 61% of high school teachers say chronic absenteeism is a major problem at their school, compared with 43% of elementary school teachers and 46% of middle school teachers.
• 69% of high school teachers and 57% of middle school teachers say anxiety and depression are a major problem, compared with 29% of elementary school teachers.
• 34% of middle school teachers say bullying is a major problem, compared with 13% of elementary school teachers and 21% of high school teachers.

Not surprisingly, drug use, school fights, alcohol use and gangs are more likely to be viewed as major problems by secondary school teachers than by those teaching in elementary schools.

Differences by poverty level

Teachers’ views on problems students face at their school also vary by school poverty level.

Majorities of teachers in high- and medium-poverty schools say chronic absenteeism is a major problem where they teach (66% and 58%, respectively). A much smaller share of teachers in low-poverty schools say this (34%).

Bullying, school fights and gangs are viewed as major problems by larger shares of teachers in high-poverty schools than in medium- and low-poverty schools.

When it comes to anxiety and depression, a slightly larger share of teachers in low-poverty schools (51%) than in high-poverty schools (44%) say these are a major problem among students where they teach.  

Discipline practices

About two-thirds of teachers (66%) say that the current discipline practices at their school are very or somewhat mild – including 27% who say they’re very mild. Only 2% say the discipline practices at their school are very or somewhat harsh, while 31% say they are neither harsh nor mild.

We also asked teachers about the amount of influence different groups have when it comes to determining discipline practices at their school.

• 67% say teachers themselves don’t have enough influence. Very few (2%) say teachers have too much influence, and 29% say their influence is about right.

• 31% of teachers say school administrators don’t have enough influence, 22% say they have too much, and 45% say their influence is about right.
• On balance, teachers are more likely to say parents, their state government and the local school board have too much influence rather than not enough influence in determining discipline practices at their school. Still, substantial shares say these groups have about the right amount of influence.

Teachers from low- and medium-poverty schools (46% each) are more likely than those in high-poverty schools (36%) to say parents have too much influence over discipline practices.

In turn, teachers from high-poverty schools (34%) are more likely than those from low- and medium-poverty schools (17% and 18%, respectively) to say that parents don’t have enough influence.

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Table of contents, ‘back to school’ means anytime from late july to after labor day, depending on where in the u.s. you live, among many u.s. children, reading for fun has become less common, federal data shows, most european students learn english in school, for u.s. teens today, summer means more schooling and less leisure time than in the past, about one-in-six u.s. teachers work second jobs – and not just in the summer, most popular.

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What is the Great Depression?

Key factors that caused the great depression, government response and policy failures.

• Lessons learned from the Great Depression
• Could the Great Depression happen again? 

Unraveling the Causes of the Great Depression

Paid non-client promotion: Affiliate links for the products on this page are from partners that compensate us (see our advertiser disclosure with our list of partners for more details). However, our opinions are our own. See how we rate investing products to write unbiased product reviews.

• While the October 1929 stock market crash triggered the Great Depression, multiple factors turned it into a decade-long economic catastrophe.
• Overproduction, executive inaction, ill-timed tariffs, and an inexperienced Federal Reserve all contributed to the Great Depression.
• The Great Depression’s legacy includes social programs, regulatory agencies, and government efforts to influence the economy and money supply. 

Periods of economic downturn are a normal part of the business cycle, with the average US recession lasting around 10 months. But the Great Depression was a catastrophe, lasting nearly a decade and ushering in a new era of government regulations still seen today. 

Following the exorbitant economic growth of the 1920s, poor policy decisions based on stock market speculation and overproduction by businesses resulted in a large-scale economic crisis known as the Great Depression. Its causes aren't entirely dissimilar to those of recession, though compounded on a grander scale. 

Yet, if the causes of the Great Depression can be seen in other recessions, can the economy fall into another depression? 

Let's explore the economic policies leading to the Great Depression, the impact of the 1929 stock market crash, and the impact of the crisis on global economies. 

Check out Business Insider's guide to the best free stock trading apps >>

The Great Depression was the worst economic period in US history. Starting in 1929, when the stock market crashed, it lasted until 1939 when the US began mobilizing for World War II. Industrial production fell by nearly 47%, and gross domestic production (GDP) declined by 30%. Almost half of US banks collapsed, stock shares traded at a third of their previous value, and nearly one-quarter of the population was jobless.

Despite popular belief, the stock market crash of 1929 was only the start of the crisis, not the sole perpetrator. The Great Depression resulted from a multitude of different complex policy and economic factors, including ill-timed tariffs and misguided moves by the young Federal Reserve. 

"The crash was not a cause, but a triggering event," says Barry M. Mitnick, a professor of business administration and public and international affairs at the University of Pittsburgh's Katz Graduate School of Business .

The average US recession between WWII and today is 10 months, according to data from the National Bureau of Economic Research . However, the Great Depression ravaged the economy for roughly a decade.

Economic landscape preceding the Depression

The lavish economy of the "Roaring Twenties" preceded the crash of the Great Depression. Between 1922 and 1929 was a time of exorbitant economic growth.

The gross national product grew at an average annual rate of 4.7%, while the unemployment rate dropped from 6.7% to 3.2%. Total wealth in the US more than doubled, though most of that growth was experienced by the wealthiest Americans. Individual Americans also started investing in the market in a big way. 

But all was not as roaring as it seemed. Consumers were spending more than they could afford, and companies over-produced to keep up with the demand. Financial institutions became heavily involved in stock market speculation. In some cases, they created subsidiaries that offered their own securities. Brokers secretly sold their own stocks — what would be a clear conflict of interest today.

Still, the stock market stubbornly kept on climbing. That is, until October 1929, when it all came tumbling down.

The stock market crash of 1929

The stock market crash of 1929 wasn't a one-day event but rather a week of escalating panic. On October 24 — a day now known as Black Thursday — the markets opened a staggering 11% lower than the previous day. Investors who had caught on to the market's overheated situation had begun rapidly selling their shares, sending a shockwave through Wall Street. 

The market rallied briefly, but share prices plunged another 13% the following Monday (aka Black Monday). Many investors couldn't make their margin calls. Panic caused more investors to sell, further accelerating the crash. 

"The system fell back on itself like a house of cards," says Mitnick.

The stock market lost more than 85% of its value from 1929 to July 1932. The Dow Jones Industrial Average sank from a 381.17 high in 1929 to a 41.22 low in 1932. 

Oversupply and overproduction problems

Mass production sparked the consumption boom of the 1920s, leading businesses to overproduce products. Even before the crash, businesses had to start selling goods at a loss. 

A similar crisis was occurring in agriculture. Farmers were in debt during World War I after buying more machinery to boost production. However, in the post-war economy, they produced more supply than consumer needs. Land and crop values plummeted. 

In turn, the price of agricultural and industrial products dropped, which decimated profits and hurt already over-extended enterprises. 

Low demand, high unemployment

During periods of economic recession, consumers stop spending, which forces companies to cut production. With less output, companies start laying people off, raising unemployment.

A healthy unemployment rate in the US hovers between 3% to 5%. During the peak of the Great Depression, the unemployment rate peaked at 24.9% in 1933 — 12.8 million Americans out of a population of 125.6 million — and it was still as high as 17.2% in 1939 . 

Banking failures and financial panic

Weak regulations had opened the way for wild speculation on stock exchanges. Being "in the market" was the "in" thing, but many investors weren't making choices based on research or fundamentals. Rather, they were just gambling that the stock would keep going up.

Even worse, many people bought shares on margin not realizing they'd be on the hook for the whole amount if the price fell. The result was inflated prices, with shares selling for more money than justified by their companies' actual earnings.

Moreover, the Fed followed the " liquidationist " policy of then-Treasury Secretary Andrew Mellon, in which the central bank stands aside and lets troubled banks collapse. Theoretically, a stronger, sounder banking system would emerge. The policy ended up taking out smaller banks, not necessarily bad banks. By 1933, 11,000 of them had failed, wiping out the savings of millions.

Ultimately, the decrease in the money supply led to deflation. That, in turn, caused sky-high increases in real interest rates, which choked off any chances of companies investing or expanding.

International trade and tariff policies

As demand declined, big business and agriculture, feeling the effect of cheap goods from abroad, lobbied for protection. The role of trade tariffs in the Great Depression negatively impacted the interconnectedness of global financial systems. Congress obliged with the United States Tariff Act of 1930, aka the Smoot-Hawley bill , which raised tariffs on foreign products by about 20%. 

Multiple countries retaliated with their own tariffs on US goods. The inevitable result was a trade meltdown. In the next two years, US imports fell 40%. 

No markets abroad. No demand at home. Small wonder that economic activity ground to a standstill. 

The role of monetary policy

During the Great Depression and years after, blame initially fell on the private sector, with accusations that banks had recklessly depleted their reserves. However, a groundbreaking 1963 study by economists Milton Friedman and Anna Schwartz revealed that the Fed's monetary policy was largely to blame. 

In 2002, Ben Bernanke, a Board of Governors of the Federal Reserve member, said as much . "I would like to say to Milton and Anna: Regarding the Great Depression. You're right; we did it. We're very sorry. But thanks to you, we won't do it again," Bernanke said in an address during Friedman's 90th birthday. 

Federal Reserve's mistakes during the Great Depression contributed to the heady expansion. Interest rates were kept low in the early to mid-1920s, then increased after the crash, doubling in 1931 from their pre-crash levels. The idea was to discourage lending and borrowing by stopping the "wild speculating" that encouraged the market to bubble and burst.

Fiscal policies and unemployment

President Herbert Hoover's response to the economic crisis was tardy. A believer in minimal government intervention, which he called "rugged individualism," Hoover considered direct public relief character-weakening. He did eventually start spending and launched lending and public works projects. Still, according to many economists, it was too little, too late.

The severity of the Depression forced the government to take a more hands-on relief effort. Increased government spending through direct relief programs and infrastructure projects provided more jobs, while simultaneously helping struggling families access unemployment benefits and welfare. However, these programs were funded by controversial budget deficits aimed at re-stimulating the economy. 

Banking reforms were also enacted to regulate financial institutions and prevent further reckless practices. Prior to the crash, bank deposits lacked protection and led to folks withdrawal ing their savings in a panic. Thus, policymakers created the Federal Deposit Insurance Corporation (FDIC) to reduce bank runs and restore trust in the banking system. 

Concluding analysis: Lessons learned from the Great Depression

The new deal.

When Franklin D. Roosevelt became president in 1933, he quickly began pushing through Congress a series of programs and projects called the New Deal . How much the New Deal actually alleviated the depression is a matter of some debate, as production remained low and unemployment high throughout the decade. 

But the New Deal did more than attempt to stabilize the economy, relieve jobless Americans, create previously unheard of safety net programs, and regulate the private sector. It also reshaped the role of government with programs that are now part of the fabric of American society. 

Among the New Deal's accomplishments:

• Worker protections , like the National Labor Relations Act, which legitimized unions, collective bargaining, and other employee rights
• Public works programs , aimed at providing employment via construction projects — a win-win for society and individuals 
• Individual safety nets , such as the Social Security Act of 1935, which created the pension system still with us today, and unemployment insurance

A legacy of government regulation

New Deal legislation ushered in a new era of government regulations — and the underlying concept that even a free-enterprise system can use some federal oversight. Milestone measures include:

• The Glass-Steagall Act of 1933 , which separated investment banking from commercial banking to prevent conflicts of interest and the sort of speculation that led to the 1929 crash (it was repealed in 1999, though some of its regulations remain in the Dodd-Frank Act of 2010) 
• The Federal Deposit Insurance Corporation (FDIC) oversees banks and protects consumer accounts, via FDIC deposit insurance
• The establishment of the Securities and Exchange Commission  (SEC) to oversee the stock market, create securities legislation, and protect investors from fraudulent practices

"The biggest legacy is a change in the view of government's responsibilities — that it should take an active part in addressing economic and social problems," says Aleksandar Tomic, program director of Master of Science in Applied Economics at Boston College .

The Great Depression — Frequently asked questions (FAQs)

Many economists and historians believe that the Great Depression could have been avoided, or at least mitigated, with better policy decisions and quicker government actions. Some economic downturns were inevitable due to excessive stock market speculation and consumer overspending. 

The Great Depression lasted until 1939 when the US began mobilizing for World War II. The enactment of the New Deal and the increased wartime spending helped the US economy to recover as countries abandoned the gold standard and initiated more aggressive fiscal and monetary policies. 

The Great Depression had a significant and lasting impact on global economies. The US raised tariffs on foreign products by about 20%, causing some countries to implement their own tariffs on US goods. The trade meltdown, severe deflation, and high unemployment affected not only the US but other countries, including Europe, Japan, and Latin America. The interconnectedness of global financial systems suffered a major blow, leading to significant political changes in many countries. 

The social consequences of the Great Depression devastated everyday people who faced widespread panic amidst increased homelessness, poverty, and a loss of savings due to bank failures. Families struggled to afford basic necessities like food and shelter. Soup kitchens and bread lines were common as economic hardship led to significant unemployment and financial insecurity. 

Could the Great Depression happen again? 

"The highest unemployment rate since the Great Depression" screamed headlines in April 2020, when the jobless level hit 14.7% of the US population. Since the initial spike, unemployment rates have dropped back to healthy rates, sitting at 3.9% as of February 2024 . 

January 2024, the S&P 500 reached its first record high in two years and officially became a bull market after its low point in October 2022. Amidst the AI boom, mega-cap tech stocks like Nvidia have surged more than 264% and are expected to keep growing. 

The Feds raised interest rates back in 2022 to stem rising inflation . But with inflation receding and after its December 2023 meeting, the US Federal Reserve will likely be cutting interest multiple times by the end of 2024.

Though there's by no means a consensus, many economists argue that another such catastrophe, at least one caused by internal factors, is unlikely. That's largely because the contemporary federal government can draw on many more policy and monetary tools, ranging from unemployment compensation to easing the money supply.

As, indeed, it has done. Take the Great Recession of 2007 to 2009, for example. It, too was kicked into high gear by a financial-market crisis, the subprime loan meltdown. But the Fed quickly slashed interest rates. And thanks largely to a massive government bailout of the banking, insurance, and automobile industries and an $800 billion-plus stimulus package, the downturn officially lasted less than two years. The economy recovered — albeit sluggishly — and eventually sparked a record-breaking bull market.

Though economic downturns may trigger memories of the Great Depression, nowadays, says Brad Cornell, managing director of Berkeley Research Group, "we know enough and can respond quickly enough so that these sorts of endogenous downward spirals are not going to happen again."

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Guest Essay

Elite College Admissions Have Turned Students Into Brands

By Sarah Bernstein

Ms. Bernstein is a playwright, a writing coach and an essayist in Brooklyn.

“I just can’t think of anything,” my student said.

After 10 years of teaching college essay writing, I was familiar with this reply. For some reason, when you’re asked to recount an important experience from your life, it is common to forget everything that has ever happened to you. It’s a long-form version of the anxiety that takes hold at a corporate retreat when you’re invited to say “one interesting thing about yourself,” and you suddenly believe that you are the most boring person in the entire world. Once during a version of this icebreaker, a man volunteered that he had only one kidney, and I remember feeling incredibly jealous of him.

I tried to jog this student’s memory. What about his love of music? Or his experience learning English? Or that time on a summer camping trip when he and his friends had nearly drowned? “I don’t know,” he said with a sigh. “That all seems kind of cliché.”

Applying to college has always been about standing out. When I teach college essay workshops and coach applicants one on one, I see my role as helping students to capture their voice and their way of processing the world, things that are, by definition, unique to each individual. Still, many of my students (and their parents) worry that as getting into college becomes increasingly competitive, this won’t be enough to set them apart.

Their anxiety is understandable. On Thursday, in a tradition known as “Ivy Day,” all eight Ivy League schools released their regular admission decisions. Top colleges often issue statements about how impressive (and competitive) their applicant pools were this cycle. The intention is to flatter accepted students and assuage rejected ones, but for those who have not yet applied to college, these statements reinforce the fear that there is an ever-expanding cohort of applicants with straight A’s and perfect SATs and harrowing camping trip stories all competing with one another for a vanishingly small number of spots.

This scarcity has led to a boom in the college consulting industry, now estimated to be a $2.9 billion business. In recent years, many of these advisers and companies have begun to promote the idea of personal branding — a way for teenagers to distinguish themselves by becoming as clear and memorable as a good tagline.

While this approach often leads to a strong application, students who brand themselves too early or too definitively risk missing out on the kind of exploration that will prepare them for adult life.

Like a corporate brand, the personal brand is meant to distill everything you stand for (honesty, integrity, high quality, low prices) into a cohesive identity that can be grasped at a glance. On its website, a college prep and advising company called Dallas Admissions explains the benefits of branding this way: “Each person is complex, yet admissions officers only have a small amount of time to spend learning about each prospective student. The smart student boils down key aspects of himself or herself into their personal ‘brand’ and sells that to the college admissions officer.”

Identifying the key aspects of yourself may seem like a lifelong project, but unfortunately, college applicants don’t have that kind of time. Online, there are dozens of lesson plans and seminars promising to walk students through the process of branding themselves in five to 10 easy steps. The majority begin with questions I would have found panic-inducing as a teenager, such as, “What is the story you want people to tell about you when you’re not in the room?”

Where I hoped others would describe me as “normal” or, in my wildest dreams, “cool,” today’s teenagers are expected to leave this exercise with labels like, Committed Athlete and Compassionate Leader or Environmentally Conscious Musician. Once students have a draft of their ideal self, they’re offered instructions for manifesting it (or at least, the appearance of it) in person and online. These range from common-sense tips (not posting illegal activity on social media) to more drastic recommendations (getting different friends).

It’s not just that these courses cut corners on self-discovery; it’s that they get the process backward. A personal brand is effective only if you can support it with action, so instead of finding their passion and values through experience, students are encouraged to select a passion as early as possible and then rack up the experience to substantiate it. Many college consultants suggest beginning to align your activities with your college ambitions by ninth grade, while the National Institute of Certified College Planners recommends students “talk with parents, guardians, and/or an academic adviser to create a clear plan for your education and career-related goals” in junior high.

The idea of a group of middle schoolers soberly mapping out their careers is both comical and depressing, but when I read student essays today, I can see that this advice is getting through. Over the past few years, I have been struck by how many high school seniors already have defined career goals as well as a C.V. of relevant extracurriculars to go with them. This widens the gap between wealthy students and those who lack the resources to secure a fancy research gig or start their own small business. (A shocking number of college applicants claim to have started a small business.) It also puts pressure on all students to define themselves at a moment when they are anxious to fit in and yet changing all the time.

In the world of branding, a word that appears again and again is “consistency.” If you are Charmin, that makes sense. People opening a roll of toilet paper do not want to be surprised. If you are a teenage human being, however, that is an unreasonable expectation. Changing one’s interests, opinions and presentation is a natural part of adolescence and an instructive one. I find that my students with scattershot résumés are often the most confident. They’re not afraid to push back against suggestions that ring false and will insist on revising their essay until it actually “feels like me.” On the other hand, many of my most accomplished students are so quick to accept feedback that I am wary of offering it, lest I become one more adult trying to shape them into an admission-worthy ideal.

I understand that for parents, prioritizing exploration can feel like a risky bet. Self-insight is hard to quantify and to communicate in a college application. When it comes to building a life, however, this kind of knowledge has more value than any accolade, and it cannot be generated through a brainstorming exercise in a six-step personal branding course online. To equip kids for the world, we need to provide them not just with opportunities for achievement, but with opportunities to fail, to learn, to wander and to change their minds.

In some ways, the college essay is a microcosm of modern adolescence. Depending on how you look at it, it’s either a forum for self-discovery or a high-stakes test you need to ace. I try to assure my students that it is the former. I tell them that it’s a chance to take stock of everything you’ve experienced and learned over the past 18 years and everything you have to offer as a result.

That can be a profound process. But to embark on it, students have to believe that colleges really want to see the person behind the brand. And they have to have the chance to know who that person is.

Sarah Bernstein is a playwright, a writing coach and an essayist.

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